1
|
ElHady AK, El-Gamil DS, Abdel-Halim M, Abadi AH. Advancements in Phosphodiesterase 5 Inhibitors: Unveiling Present and Future Perspectives. Pharmaceuticals (Basel) 2023; 16:1266. [PMID: 37765073 PMCID: PMC10536424 DOI: 10.3390/ph16091266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/25/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
Phosphodiesterase 5 (PDE5) inhibitors presented themselves as important players in the nitric oxide/cGMP pathway, thus exerting a profound impact on various physiological and pathological processes. Beyond their well-known efficacy in treating male erectile dysfunction (ED) and pulmonary arterial hypertension (PAH), a plethora of studies have unveiled their significance in the treatment of a myriad of other diseases, including cognitive functions, heart failure, multiple drug resistance in cancer therapy, immune diseases, systemic sclerosis and others. This comprehensive review aims to provide an updated assessment of the crucial role played by PDE5 inhibitors (PDE5-Is) as disease-modifying agents taking their limiting side effects into consideration. From a medicinal chemistry and drug discovery perspective, the published PDE5-Is over the last 10 years and their binding characteristics are systemically discussed, and advancement in properties is exposed. A persistent challenge encountered with these agents lies in their limited isozyme selectivity; considering this obstacle, this review also highlights the breakthrough development of the recently reported PDE5 allosteric inhibitors, which exhibit an unparalleled level of selectivity that was rarely achievable by competitive inhibitors. The implications and potential impact of these novel allosteric inhibitors are meticulously explored. Additionally, the concept of multi-targeted ligands is critically evaluated in relation to PDE5-Is by inspecting the broader spectrum of their molecular interactions and effects. The objective of this review is to provide insight into the design of potent, selective PDE5-Is and an overview of their biological function, limitations, challenges, therapeutic potentials, undergoing clinical trials, future prospects and emerging uses, thus guiding upcoming endeavors in both academia and industry within this domain.
Collapse
Affiliation(s)
- Ahmed K. ElHady
- School of Life and Medical Sciences, University of Hertfordshire Hosted by Global Academic Foundation, New Administrative Capital, Cairo 11865, Egypt;
| | - Dalia S. El-Gamil
- Department of Chemistry, Faculty of Pharmacy, Ahram Canadian University, Cairo 12451, Egypt;
| | - Mohammad Abdel-Halim
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Biotechnology, German University in Cairo, Cairo 11835, Egypt;
| | - Ashraf H. Abadi
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Biotechnology, German University in Cairo, Cairo 11835, Egypt;
| |
Collapse
|
2
|
Mirhadi E, Kesharwani P, Johnston TP, Sahebkar A. Nanomedicine-mediated therapeutic approaches for pulmonary arterial hypertension. Drug Discov Today 2023; 28:103599. [PMID: 37116826 DOI: 10.1016/j.drudis.2023.103599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/29/2023] [Accepted: 04/21/2023] [Indexed: 04/30/2023]
Abstract
Nanomedicine has emerged as a field in which there are opportunities to improve the diagnosis, treatment and prevention of incurable diseases. Pulmonary arterial hypertension (PAH) is known as a severe and fatal disease affecting children and adults. Conventional treatments have not produced optimal effectiveness in treating this condition. Several reasons for this include drug instability, poor solubility of the drug and a shortened duration of pharmacological action. The present review focuses on new approaches for delivering anti-PAH drugs using nanotechnology with the aim of overcoming these shortcomings and increasing their efficacy. Solid-lipid nanoparticles, liposomes, metal-organic frameworks and polymeric nanoparticles have demonstrated advantages for the potential treatment of PAH, including increased drug bioavailability, drug solubility and accumulation in the lungs.
Collapse
Affiliation(s)
- Elaheh Mirhadi
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India; Center for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Science, Chennai, India
| | - Thomas P Johnston
- Division of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
| |
Collapse
|
3
|
Mandras S, Kovacs G, Olschewski H, Broderick M, Nelsen A, Shen E, Champion H. Combination Therapy in Pulmonary Arterial Hypertension-Targeting the Nitric Oxide and Prostacyclin Pathways. J Cardiovasc Pharmacol Ther 2021; 26:453-462. [PMID: 33836637 PMCID: PMC8261771 DOI: 10.1177/10742484211006531] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Pulmonary arterial hypertension (PAH) is a chronic and progressive disorder
characterized by vascular remodeling of the small pulmonary arteries, resulting
in elevated pulmonary vascular resistance and ultimately, right ventricular
failure. Expanded understanding of PAH pathophysiology as it pertains to the
nitric oxide (NO), prostacyclin (prostaglandin I2) (PGI2)
and endothelin-1 pathways has led to recent advancements in targeted drug
development and substantial improvements in morbidity and mortality. There are
currently several classes of drugs available to target these pathways including
phosphodiesterase-5 inhibitors (PDE5i), soluble guanylate cyclase (sGC)
stimulators, prostacyclin class agents and endothelin receptor antagonists
(ERAs). Combination therapy in PAH, either upfront or sequentially, has become a
widely adopted treatment strategy, allowing for simultaneous targeting of more
than one of these signaling pathways implicated in disease progression. Much of
the current treatment landscape has focused on initial combination therapy with
ambrisentan and tadalafil, an ERA and PDE5I respectively, following results of
the AMBITION study demonstrating combination to be superior to either agent
alone as upfront therapy. Consequently, clinicians often consider combination
therapy with other drugs and drug classes, as deemed clinically appropriate, for
patients with PAH. An alternative regimen that targets the NO and
PGI2 pathways has been adopted by some clinicians as an effective
and sometimes preferred therapeutic combination for PAH. Although there is a
paucity of prospective data, preclinical data and results from secondary data
analysis of clinical studies targeting these pathways may provide novel insights
into this alternative combination as a reasonable, and sometimes preferred,
alternative approach to combination therapy in PAH. This review of preclinical
and clinical data will discuss the current understanding of combination therapy
that simultaneously targets the NO and PGI2 signaling pathways,
highlighting the clinical advantages and theoretical biochemical interplay of
these agents.
Collapse
Affiliation(s)
| | - Gabor Kovacs
- Medical University of Graz, 580955Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | - Horst Olschewski
- Medical University of Graz, 580955Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | | | - Andrew Nelsen
- United Therapeutics Corporation, Research Triangle Park, NC, USA
| | - Eric Shen
- United Therapeutics Corporation, Research Triangle Park, NC, USA
| | - Hunter Champion
- Division of Cardiology, 12241Mercer University School of Medicine, Macon, GA, USA
| |
Collapse
|
4
|
Abstract
Pulmonary arterial hypertension (PAH) is a life‐threatening disease characterized by increased pulmonary arterial pressure and pulmonary vascular resistance, which result in an increase in afterload imposed onto the right ventricle, leading to right heart failure. Current therapies are incapable of reversing the disease progression. Thus, the identification of novel and potential therapeutic targets is urgently needed. An alteration of nucleotide‐ and nucleoside‐activated purinergic signaling has been proposed as a potential contributor in the pathogenesis of PAH. Adenosine‐mediated purinergic 1 receptor activation, particularly A2AR activation, reduces pulmonary vascular resistance and attenuates pulmonary vascular remodeling and right ventricle hypertrophy, thereby exerting a protective effect. Conversely, A2BR activation induces pulmonary vascular remodeling, and is therefore deleterious. ATP‐mediated P2X7R activation and ADP‐mediated activation of P2Y1R and P2Y12R play a role in pulmonary vascular tone, vascular remodeling, and inflammation in PAH. Recent studies have revealed a role of ectonucleotidase nucleoside triphosphate diphosphohydrolase, that degrades ATP/ADP, in regulation of pulmonary vascular remodeling. Interestingly, existing evidence that adenosine activates erythrocyte A2BR signaling, counteracting hypoxia‐induced pulmonary injury, and that ATP release is impaired in erythrocyte in PAH implies erythrocyte dysfunction as an important trigger to affect purinergic signaling for pathogenesis of PAH. The present review focuses on current knowledge on alteration of nucleot(s)ide‐mediated purinergic signaling as a potential disease mechanism underlying the development of PAH.
Collapse
Affiliation(s)
- Zongye Cai
- Division of Experimental Cardiology Department of Cardiology Erasmus MCUniversity Medical Center Rotterdam Rotterdam the Netherlands
| | - Ly Tu
- INSERM UMR_S 999Hôpital Marie Lannelongue Le Plessis-Robinson France.,School of Medicine Université Paris-Saclay Kremlin-Bicêtre France
| | - Christophe Guignabert
- INSERM UMR_S 999Hôpital Marie Lannelongue Le Plessis-Robinson France.,School of Medicine Université Paris-Saclay Kremlin-Bicêtre France
| | - Daphne Merkus
- Division of Experimental Cardiology Department of Cardiology Erasmus MCUniversity Medical Center Rotterdam Rotterdam the Netherlands.,Walter Brendel Center of Experimental Medicine LMU Munich Munich Germany.,German Center for Cardiovascular Research, Partner Site MunichMunich Heart Alliance Munich Germany
| | - Zhichao Zhou
- Division of Cardiology Department of Medicine Karolinska University HospitalKarolinska Institutet Stockholm Sweden
| |
Collapse
|
5
|
Marginedas-Freixa I, Alvarez CL, Moras M, Leal Denis MF, Hattab C, Halle F, Bihel F, Mouro-Chanteloup I, Lefevre SD, Le Van Kim C, Schwarzbaum PJ, Ostuni MA. Human erythrocytes release ATP by a novel pathway involving VDAC oligomerization independent of pannexin-1. Sci Rep 2018; 8:11384. [PMID: 30061676 PMCID: PMC6065367 DOI: 10.1038/s41598-018-29885-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 07/20/2018] [Indexed: 12/14/2022] Open
Abstract
We previously demonstrated that the translocase protein TSPO2 together with the voltage-dependent anion channel (VDAC) and adenine nucleotide transporter (ANT) were involved in a membrane transport complex in human red blood cells (RBCs). Because VDAC was proposed as a channel mediating ATP release in RBCs, we used TSPO ligands together with VDAC and ANT inhibitors to test this hypothesis. ATP release was activated by TSPO ligands, and blocked by inhibitors of VDAC and ANT, while it was insensitive to pannexin-1 blockers. TSPO ligand increased extracellular ATP (ATPe) concentration by 24–59% over the basal values, displaying an acute increase in [ATPe] to a maximal value, which remained constant thereafter. ATPe kinetics were compatible with VDAC mediating a fast but transient ATP efflux. ATP release was strongly inhibited by PKC and PKA inhibitors as well as by depleting intracellular cAMP or extracellular Ca2+, suggesting a mechanism involving protein kinases. TSPO ligands favoured VDAC polymerization yielding significantly higher densities of oligomeric bands than in unstimulated cells. Polymerization was partially inhibited by decreasing Ca2+ and cAMP contents. The present results show that TSPO ligands induce polymerization of VDAC, coupled to activation of ATP release by a supramolecular complex involving VDAC, TSPO2 and ANT.
Collapse
Affiliation(s)
- Irene Marginedas-Freixa
- UMR-S1134, Integrated Biology of Red Blood Cells, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Université de la Réunion, Université des Antilles, F-75015, Paris, France.,Institut National de la Transfusion Sanguine, Laboratoire d'Excellence GR-Ex, F-75015, Paris, France
| | - Cora Lilia Alvarez
- Instituto de Química y Fisico-Química Biológicas "Prof. Alejandro C. Paladini", UBA, CONICET, Facultad de Farmacia y Bioquímica, Junín 956, Buenos Aires, Argentina.,Universidad de Buenos Aires. Facultad Ciencias Exactas y Naturales, Departamento de Biodiversidad y Biología Experimental, Buenos Aires, Argentina
| | - Martina Moras
- UMR-S1134, Integrated Biology of Red Blood Cells, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Université de la Réunion, Université des Antilles, F-75015, Paris, France.,Institut National de la Transfusion Sanguine, Laboratoire d'Excellence GR-Ex, F-75015, Paris, France
| | - María Florencia Leal Denis
- Instituto de Química y Fisico-Química Biológicas "Prof. Alejandro C. Paladini", UBA, CONICET, Facultad de Farmacia y Bioquímica, Junín 956, Buenos Aires, Argentina.,Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Química Analítica y Fisicoquímica, Cátedra de Química Analítica, Buenos Aires, Argentina
| | - Claude Hattab
- UMR-S1134, Integrated Biology of Red Blood Cells, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Université de la Réunion, Université des Antilles, F-75015, Paris, France.,Institut National de la Transfusion Sanguine, Laboratoire d'Excellence GR-Ex, F-75015, Paris, France
| | - François Halle
- UMR7200, Laboratoire d'Innovation Thérapeutique, Faculty of Pharmacy, University of Strasbourg, CNRS, 67400, Illkirch Graffenstaden, France
| | - Frédéric Bihel
- UMR7200, Laboratoire d'Innovation Thérapeutique, Faculty of Pharmacy, University of Strasbourg, CNRS, 67400, Illkirch Graffenstaden, France
| | - Isabelle Mouro-Chanteloup
- UMR-S1134, Integrated Biology of Red Blood Cells, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Université de la Réunion, Université des Antilles, F-75015, Paris, France.,Institut National de la Transfusion Sanguine, Laboratoire d'Excellence GR-Ex, F-75015, Paris, France
| | - Sophie Denise Lefevre
- UMR-S1134, Integrated Biology of Red Blood Cells, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Université de la Réunion, Université des Antilles, F-75015, Paris, France.,Institut National de la Transfusion Sanguine, Laboratoire d'Excellence GR-Ex, F-75015, Paris, France
| | - Caroline Le Van Kim
- UMR-S1134, Integrated Biology of Red Blood Cells, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Université de la Réunion, Université des Antilles, F-75015, Paris, France.,Institut National de la Transfusion Sanguine, Laboratoire d'Excellence GR-Ex, F-75015, Paris, France
| | - Pablo Julio Schwarzbaum
- Instituto de Química y Fisico-Química Biológicas "Prof. Alejandro C. Paladini", UBA, CONICET, Facultad de Farmacia y Bioquímica, Junín 956, Buenos Aires, Argentina.,Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Química Biológica. Cátedra de Química Biológica Superior, Buenos Aires, Argentina
| | - Mariano Anibal Ostuni
- UMR-S1134, Integrated Biology of Red Blood Cells, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Université de la Réunion, Université des Antilles, F-75015, Paris, France. .,Institut National de la Transfusion Sanguine, Laboratoire d'Excellence GR-Ex, F-75015, Paris, France.
| |
Collapse
|
6
|
Liposomal-delivery of phosphodiesterase 5 inhibitors augments UT-15C-stimulated ATP release from human erythrocytes. Biochem Biophys Rep 2017; 12:114-119. [PMID: 28955799 PMCID: PMC5613235 DOI: 10.1016/j.bbrep.2017.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 08/09/2017] [Accepted: 09/09/2017] [Indexed: 11/21/2022] Open
Abstract
The use of liposomes to affect targeted delivery of pharmaceutical agents to specific sites may result in the reduction of side effects and an increase in drug efficacy. Since liposomes are delivered intravascularly, erythrocytes, which constitute almost half of the volume of blood, are ideal targets for liposomal drug delivery. In vivo, erythrocytes serve not only in the role of oxygen transport but also as participants in the regulation of vascular diameter through the regulated release of the potent vasodilator, adenosine triphosphate (ATP). Unfortunately, erythrocytes of humans with pulmonary arterial hypertension (PAH) do not release ATP in response to the physiological stimulus of exposure to increases in mechanical deformation as would occur when these cells traverse the pulmonary circulation. This defect in erythrocyte physiology has been suggested to contribute to pulmonary hypertension in these individuals. In contrast to deformation, both healthy human and PAH erythrocytes do release ATP in response to incubation with prostacyclin analogs via a well-characterized signaling pathway. Importantly, inhibitors of phosphodiesterase 5 (PDE5) have been shown to significantly increase prostacyclin analog-induced ATP release from human erythrocytes. Here we investigate the hypothesis that targeted delivery of PDE5 inhibitors to human erythrocytes, using a liposomal delivery system, potentiates prostacyclin analog- induced ATP release. The findings are consistent with the hypothesis that directed delivery of this class of drugs to erythrocytes could be a new and important method to augment prostacyclin analog-induced ATP release from these cells. Such an approach could significantly limit side effects of both classes of drugs without compromising their therapeutic effectiveness in diseases such as PAH. PDE5 inhibitors can be successfully delivered to human erythrocytes via liposomes. This results in augmented PGI2 analog-mediated ATP release. Liposomal binding to erythrocytes is rapid without affecting erythrocyte rheology. This is a novel method to augment PGI2 analog-induced ATP release from erythrocytes.
Collapse
Key Words
- ATP, (adenosine triphosphate)
- DMPC, (1,2-Dimyristoyl-sn-glycero-3-phosphocholine)
- FSC, (forward scatter)
- Liposomes
- PAH, (pulmonary arterial hypertension)
- PDE, (phosphodiesterase)
- PGI2, (prostacyclin)
- PSS, (physiological salt solution)
- Red blood cell
- SSC, (side scatter)
- TAD, (tadalafil)
- Tadalafil
- Tadalafil (PubChem CID: 110635)
- Treprostinil
- UT-15C
- UT-15C (PubChem CID: 691840)
- ZAP, (zaprinast),
- Zaprinast
- Zaprinast (PubChem CID: 5722)
- cAMP, (cyclic adenosine monophosphate)
- cGMP, (cyclic guanosine monophosphate)
- sGC, (soluble guanylyl cyclase)
Collapse
|
7
|
Keller AS, Diederich L, Panknin C, DeLalio LJ, Drake JC, Sherman R, Jackson EK, Yan Z, Kelm M, Cortese-Krott MM, Isakson BE. Possible roles for ATP release from RBCs exclude the cAMP-mediated Panx1 pathway. Am J Physiol Cell Physiol 2017; 313:C593-C603. [PMID: 28855161 DOI: 10.1152/ajpcell.00178.2017] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 08/23/2017] [Accepted: 08/23/2017] [Indexed: 01/21/2023]
Abstract
Red blood cell (RBC)-derived adenosine triphosphate (ATP) has been proposed as an integral component in the regulation of oxygen supply to skeletal muscle. In ex vivo settings RBCs have been shown to release ATP in response to a number of stimuli, including stimulation of adrenergic receptors. Further evidence suggested that ATP release from RBCs was dependent on activation of adenylate cyclase (AC)/cyclic adenosine monophosphate (cAMP)-dependent pathways and involved the pannexin 1 (Panx1) channel. Here we show that RBCs express Panx1 and confirm its absence in Panx1 knockout (-/-) RBCs. However, Panx1-/- mice lack any decrease in exercise performance, challenging the assumptions that Panx1 plays an essential role in increased blood perfusion to exercising skeletal muscle and therefore in ATP release from RBCs. We therefore tested the role of Panx1 in ATP release from RBCs ex vivo in RBC suspensions. We found that stimulation with hypotonic potassium gluconate buffer resulted in a significant increase in ATP in the supernatant, but this was highly correlated with RBC lysis. Next, we treated RBCs with a stable cAMP analog, which did not induce ATP release from wild-type or Panx1-/- mice. Similarly, multiple pharmacological treatments activating AC in RBCs increased intracellular cAMP levels (as measured via mass spectrometry) but did not induce ATP release. The data presented here question the importance of Panx1 for exercise performance and dispute the general assumption that ATP release from RBCs via Panx1 is regulated via cAMP.
Collapse
Affiliation(s)
- Alexander S Keller
- Department of Pharmacology, University of Virginia School of Medicine, Charlottesville, Virginia.,Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Lukas Diederich
- Cardiovascular Research Laboratory, Division of Cardiology, Pneumology, and Vascular Medicine, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Christina Panknin
- Cardiovascular Research Laboratory, Division of Cardiology, Pneumology, and Vascular Medicine, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Leon J DeLalio
- Department of Pharmacology, University of Virginia School of Medicine, Charlottesville, Virginia.,Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Joshua C Drake
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Robyn Sherman
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Edwin Kerry Jackson
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania; and
| | - Zhen Yan
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, Virginia.,Department of Molecular Physiology and Biophysics, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Malte Kelm
- Cardiovascular Research Laboratory, Division of Cardiology, Pneumology, and Vascular Medicine, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Miriam M Cortese-Krott
- Cardiovascular Research Laboratory, Division of Cardiology, Pneumology, and Vascular Medicine, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany;
| | - Brant E Isakson
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, Virginia.,Department of Molecular Physiology and Biophysics, University of Virginia School of Medicine, Charlottesville, Virginia
| |
Collapse
|
8
|
Burnstock G. Purinergic Signaling in the Cardiovascular System. Circ Res 2017; 120:207-228. [PMID: 28057794 DOI: 10.1161/circresaha.116.309726] [Citation(s) in RCA: 267] [Impact Index Per Article: 38.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 11/21/2016] [Accepted: 11/23/2016] [Indexed: 02/07/2023]
Abstract
There is nervous control of the heart by ATP as a cotransmitter in sympathetic, parasympathetic, and sensory-motor nerves, as well as in intracardiac neurons. Centers in the brain control heart activities and vagal cardiovascular reflexes involve purines. Adenine nucleotides and nucleosides act on purinoceptors on cardiomyocytes, AV and SA nodes, cardiac fibroblasts, and coronary blood vessels. Vascular tone is controlled by a dual mechanism. ATP, released from perivascular sympathetic nerves, causes vasoconstriction largely via P2X1 receptors. Endothelial cells release ATP in response to changes in blood flow (via shear stress) or hypoxia, to act on P2 receptors on endothelial cells to produce nitric oxide, endothelium-derived hyperpolarizing factor, or prostaglandins to cause vasodilation. ATP is also released from sensory-motor nerves during antidromic reflex activity, to produce relaxation of some blood vessels. Purinergic signaling is involved in the physiology of erythrocytes, platelets, and leukocytes. ATP is released from erythrocytes and platelets, and purinoceptors and ectonucleotidases are expressed by these cells. P1, P2Y1, P2Y12, and P2X1 receptors are expressed on platelets, which mediate platelet aggregation and shape change. Long-term (trophic) actions of purine and pyrimidine nucleosides and nucleotides promote migration and proliferation of vascular smooth muscle and endothelial cells via P1 and P2Y receptors during angiogenesis, vessel remodeling during restenosis after angioplasty and atherosclerosis. The involvement of purinergic signaling in cardiovascular pathophysiology and its therapeutic potential are discussed, including heart failure, infarction, arrhythmias, syncope, cardiomyopathy, angina, heart transplantation and coronary bypass grafts, coronary artery disease, diabetic cardiomyopathy, hypertension, ischemia, thrombosis, diabetes mellitus, and migraine.
Collapse
Affiliation(s)
- Geoffrey Burnstock
- From the Autonomic Neuroscience Institute, Royal Free and University College Medical School, London, United Kingdom.
| |
Collapse
|
9
|
Nakahira K, Hisata S, Choi AMK. The Roles of Mitochondrial Damage-Associated Molecular Patterns in Diseases. Antioxid Redox Signal 2015; 23:1329-50. [PMID: 26067258 PMCID: PMC4685486 DOI: 10.1089/ars.2015.6407] [Citation(s) in RCA: 199] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
SIGNIFICANCE Mitochondria, vital cellular power plants to generate energy, are involved in immune responses. Mitochondrial damage-associated molecular patterns (DAMPs) are molecules that are released from mitochondria to extracellular space during cell death and include not only proteins but also DNA or lipids. Mitochondrial DAMPs induce inflammatory responses and are critically involved in the pathogenesis of various diseases. RECENT ADVANCES Recent studies elucidate the molecular mechanisms by which mitochondrial DAMPs are released and initiate immune responses by use of genetically modulated cells or animals. Importantly, the levels of mitochondrial DAMPs in patients are often associated with severity and prognosis of human diseases, such as infection, asthma, ischemic heart disease, and cancer. CRITICAL ISSUES Although mitochondrial DAMPs can represent proinflammatory molecules in various experimental models, their roles in human diseases may be multifunctional and complex. It remains unclear where and how mitochondrial DAMPs are liberated into extracellular spaces and exert their biological functions particularly in vivo. In addition, while mitochondria can secrete several types of DAMPs during cell death, the interaction of each mitochondrial DAMP (e.g., synergistic effects) remains unclear. FUTURE DIRECTIONS Regulation of mitochondrial DAMP-mediated immune responses may be important to alter the progression of human diseases. In addition, measuring mitochondrial DAMPs in patients may be clinically useful as biomarkers to predict prognosis or response to therapies. Further studies of the mechanisms by which mitochondrial DAMPs impact the initiation and progression of diseases may lead to the development of therapeutics specifically targeting this pathway. Antioxid.
Collapse
Affiliation(s)
- Kiichi Nakahira
- 1 Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medical College and New York-Presbyterian Hospital , New York, New York.,2 Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical College , New York, New York
| | - Shu Hisata
- 1 Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medical College and New York-Presbyterian Hospital , New York, New York.,2 Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical College , New York, New York
| | - Augustine M K Choi
- 1 Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medical College and New York-Presbyterian Hospital , New York, New York.,2 Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical College , New York, New York
| |
Collapse
|
10
|
Clapp LH, Gurung R. The mechanistic basis of prostacyclin and its stable analogues in pulmonary arterial hypertension: Role of membrane versus nuclear receptors. Prostaglandins Other Lipid Mediat 2015; 120:56-71. [PMID: 25917921 DOI: 10.1016/j.prostaglandins.2015.04.007] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 04/13/2015] [Indexed: 12/22/2022]
Abstract
Pulmonary arterial hypertension (PAH) is a progressive disease of distal pulmonary arteries in which patients suffer from elevated pulmonary arterial pressure, extensive vascular remodelling and right ventricular failure. To date prostacyclin (PGI2) therapy remains the most efficacious treatment for PAH and is the only approved monotherapy to have a positive impact on long-term survival. A key thing to note is that improvement exceeds that predicted from vasodilator testing strongly suggesting that additional mechanisms contribute to the therapeutic benefit of prostacyclins in PAH. Given these agents have potent antiproliferative, anti-inflammatory and endothelial regenerating properties suggests therapeutic benefit might result from a slowing, stabilization or even some reversal of vascular remodelling in vivo. This review discusses evidence that the pharmacology of each prostacyclin (IP) receptor agonist so far developed is distinct, with non-IP receptor targets clearly contributing to the therapeutic and side effect profile of PGI2 (EP3), iloprost (EP1), treprostinil (EP2, DP1) along with a family of nuclear receptors known as peroxisome proliferator-activated receptors (PPARs), to which PGI2 and some analogues directly bind. These targets are functionally expressed to varying degrees in arteries, veins, platelets, fibroblasts and inflammatory cells and are likely to be involved in the biological actions of prostacylins. Recently, a highly selective IP agonist, selexipag has been developed for PAH. This agent should prove useful in distinguishing IP from other prostanoid receptors or PPAR binding effects in human tissue. It remains to be determined whether selectivity for the IP receptor gives rise to a superior or inferior clinical benefit in PAH.
Collapse
Affiliation(s)
- Lucie H Clapp
- Department of Medicine, UCL, Rayne Building, London WC1E 6JF, UK.
| | - Rijan Gurung
- Department of Medicine, UCL, Rayne Building, London WC1E 6JF, UK
| |
Collapse
|