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Xiao H, Cui X, Liu L, Lv B, Zhang R, Zheng T, Yao D, Gao H, Gu X, Li Y, Tian Y. Identification and validation of lipid metabolism-related key genes as novel biomarkers in acute myocardial infarction and pan-cancer analysis. Aging (Albany NY) 2024; 16:9127-9146. [PMID: 38787365 PMCID: PMC11164520 DOI: 10.18632/aging.205860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/16/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Acute myocardial infarction (AMI) is associated with high morbidity and mortality, and is associated with abnormal lipid metabolism. We identified lipid metabolism related genes as biomarkers of AMI, and explored their mechanisms of action. METHODS Microarray datasets were downloaded from the GEO database and lipid metabolism related genes were obtained from Molecular Signatures Database. WGCNA was performed to identify key genes. We evaluated differential expression and performed ROC and ELISA analyses. We also explored the mechanism of AMI mediated by key genes using gene enrichment analysis. Finally, immune infiltration and pan-cancer analyses were performed for the identified key genes. RESULTS TRL2, S100A9, and HCK were identified as key genes related to lipid metabolism in AMI. Internal and external validation (including ELISA) showed that these were good biomarkers of AMI. In addition, the results of gene enrichment analysis showed that the key genes were enriched in inflammatory response, immune system process, and tumor-related pathways. Finally, the results of immune infiltration showed that key genes were concentrated in neutrophils and macrophages, and pan-cancer analysis showed that the key genes were highly expressed in most tumors and were associated with poor prognosis. CONCLUSIONS TLR2, S100A9, and HCK were identified as lipid metabolism related novel diagnostic biomarkers of AMI. In addition, AMI and tumors may be related through the inflammatory immune response.
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Affiliation(s)
- Hao Xiao
- Department of Emergency, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiaolei Cui
- Department of Emergency, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Liang Liu
- Department of Emergency, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Baopu Lv
- Department of Emergency, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Rui Zhang
- Department of Emergency, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tuokang Zheng
- Department of Emergency, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Dongqi Yao
- Department of Emergency, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hengbo Gao
- Department of Emergency, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xinshun Gu
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yi Li
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yingping Tian
- Department of Emergency, The Second Hospital of Hebei Medical University, Shijiazhuang, China
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2
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Traub J, Schürmann P, Schmitt D, Gassenmaier T, Fette G, Frantz S, Störk S, Beyersdorf N, Boivin-Jahns V, Jahns R, Hofmann U, Frey A. Features of metabolic syndrome and inflammation independently affect left ventricular function early after first myocardial infarction. Int J Cardiol 2023; 370:43-50. [PMID: 36306955 DOI: 10.1016/j.ijcard.2022.10.142] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/13/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND A high body mass index (BMI) is often associated with metabolic syndrome, which is accompanied by systemic low-grade chronic inflammation. Here, we analyzed whether BMI, other components of metabolic syndrome, and/or inflammatory markers correlate with left ventricular geometry, function, and infarct size as assessed by serial cardiac magnetic resonance imaging (MRI) after a first (clinically evident) ST-elevation MI (STEMI). METHODS Within the Etiology, Titre-Course, and effect on Survival (ETiCS) study, cardiac MRI conducted 7-9 days and 12 months after MI enabled longitudinal characterization of patients with a first STEMI along with serial routine blood counts and multiplex cytokine measurements. RESULTS Of 91 locally included STEMI patients, 47% were overweight (25 kg/m2 < BMI < 30 kg/m2) and 24% were obese (BMI ≥ 30 kg/m2). No patient died during 12 months of follow-up. Left ventricular ejection fraction (LVEF), measured 7-9 days after STEMI, was significantly lower in overweight (49.5 ± 7.1%) and obese (45.8 ± 12.0%) patients than in the normal weight group (56.2 ± 7.7%). Along with BMI (T = -3.8; p < 0.001), hemoglobin A1c (HbA1c; T = -3.1; p = 0.004) and peak C-reactive protein (T = -2.6; p = 0.013) emerged as independent predictors of worse LVEF 7-9 days post MI (R2 = 0.45). Only peak C-reactive protein (T = -4.4; p < 0.001), but not parameters of the metabolic syndrome, predicted worse LVEF 12 months after STEMI (R2 = 0.20). CONCLUSION Both BMI and HbA1c correlated negatively with LVEF only early, but not late after STEMI. Peak CRP evolved as strongest predictor of cardiac function at all time points independent of the metabolic syndrome.
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Affiliation(s)
- Jan Traub
- Department of Internal Medicine I, University Hospital Würzburg, Germany; Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany; Interdisciplinary Center for Clinical Research, University Würzburg, Germany.
| | - Paula Schürmann
- Department of Internal Medicine I, University Hospital Würzburg, Germany; Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
| | - Dominik Schmitt
- Department of Internal Medicine I, University Hospital Würzburg, Germany
| | - Tobias Gassenmaier
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Germany
| | - Georg Fette
- Data Integration Center, University Hospital Würzburg, Germany
| | - Stefan Frantz
- Department of Internal Medicine I, University Hospital Würzburg, Germany; Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
| | - Stefan Störk
- Department of Internal Medicine I, University Hospital Würzburg, Germany; Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
| | - Niklas Beyersdorf
- Institute for Virology and Immunobiology, University of Würzburg, Germany
| | - Valérie Boivin-Jahns
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany; Department of Pharmacology and Toxicology, University of Würzburg, Germany
| | - Roland Jahns
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany; Interdisciplinary Bank of Biomaterials and Data Würzburg, University Hospital and University Würzburg, Germany
| | - Ulrich Hofmann
- Department of Internal Medicine I, University Hospital Würzburg, Germany; Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
| | - Anna Frey
- Department of Internal Medicine I, University Hospital Würzburg, Germany; Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
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3
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Ellenbroek GHJM, de Haan JJ, van Klarenbosch BR, Brans MAD, van de Weg SM, Smeets MB, de Jong S, Arslan F, Timmers L, Goumans MJTH, Hoefer IE, Doevendans PA, Pasterkamp G, Meyaard L, de Jager SCA. Leukocyte-Associated Immunoglobulin-like Receptor-1 is regulated in human myocardial infarction but its absence does not affect infarct size in mice. Sci Rep 2017; 7:18039. [PMID: 29269840 PMCID: PMC5740066 DOI: 10.1038/s41598-017-13678-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 09/27/2017] [Indexed: 01/04/2023] Open
Abstract
Heart failure after myocardial infarction (MI) depends on infarct size and adverse left ventricular (LV) remodelling, both influenced by the inflammatory response. Leukocyte-associated immunoglobulin-like receptor 1 (LAIR-1) is an inhibitory receptor of ITAM-dependent cell activation, present on almost all immune cells. We investigated regulation of LAIR-1 leukocyte expression after MI in patients and hypothesized that its absence in a mouse model of MI would increase infarct size and adverse remodelling. In patients, LAIR-1 expression was increased 3 days compared to 6 weeks after MI on circulating monocytes (24.8 ± 5.3 vs. 21.2 ± 5.1 MFI, p = 0.008) and neutrophils (12.9 ± 4.7 vs. 10.6 ± 3.1 MFI, p = 0.046). In WT and LAIR-1-/- mice, infarct size after ischemia-reperfusion injury was comparable (37.0 ± 14.5 in WT vs. 39.4 ± 12.2% of the area at risk in LAIR-1-/-, p = 0.63). Remodelling after permanent left coronary artery ligation did not differ between WT and LAIR-1-/- mice (end-diastolic volume 133.3 ± 19.3 vs. 132.1 ± 27.9 μL, p = 0.91 and end-systolic volume 112.1 ± 22.2 vs. 106.9 ± 33.5 μL, p = 0.68). Similarly, no differences were observed in inflammatory cell influx or fibrosis. In conclusion, LAIR-1 expression on monocytes and neutrophils is increased in the acute phase after MI in patients, but the absence of LAIR-1 in mice does not influence infarct size, inflammation, fibrosis or adverse cardiac remodelling.
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Affiliation(s)
| | - Judith J de Haan
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Bas R van Klarenbosch
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maike A D Brans
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sander M van de Weg
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mirjam B Smeets
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sanne de Jong
- Department of Medical Physiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Fatih Arslan
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Leo Timmers
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marie-José T H Goumans
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Imo E Hoefer
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Pieter A Doevendans
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.,Netherlands Heart Institute, Utrecht, The Netherlands
| | - Gerard Pasterkamp
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Linde Meyaard
- Laboratory of Translational Immunology, Department of Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Saskia C A de Jager
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands. .,Laboratory of Translational Immunology, Department of Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
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4
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Hensel M, Grädel L, Kutz A, Haubitz S, Huber A, Mueller B, Schuetz P, Hügle T. Peripheral monocytosis as a predictive factor for adverse outcome in the emergency department: Survey based on a register study. Medicine (Baltimore) 2017; 96:e7404. [PMID: 28700476 PMCID: PMC5515748 DOI: 10.1097/md.0000000000007404] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Monocytosis is associated with chronic infections such as tuberculosis or endocarditis as well as rheumatic and myeloproliferative disorders. Monocytes are also involved in the pathogenesis of atherosclerosis, coronary artery disease, and stroke. The value of monocytosis as a prognostic marker in different diagnostic groups in the emergency setting, however, has not been investigated so far.The aim of the article is to study monocytosis as an outcome factor in the emergency setting.In a Swiss register study, we analyzed monocyte counts in 4238 patients aged >18 years who were admitted to the emergency department of a regional tertiary care hospital. Monocytosis was defined as 0.8×10 cells/L. Diagnoses were grouped into infection, cardiovascular, neurological, metabolic, gastrointestinal, pulmonary, or other. Thirty-day mortality was defined as the primary endpointA total of 1217 patients with monocytosis were identified. Patients with monocytosis at admission suffered more frequently from respiratory symptoms (17.7% vs 8.9%, P <.001) and infection as the final diagnosis (20.8% vs 10.3%, P <.001) while neurological diagnoses were significantly lower in the monocytosis group (15.3% vs 30.9%, P <.001). Patients with monocytosis suffered from more comorbidities such as congestive heart failure, chronic obstructive pulmonary disease, tumor, diabetes, or renal failure but not dementia. When adjusted for age, gender, comorbidities, and main diagnosis, the 30-day mortality (P = .002) and length of stay (P = .001) were significantly higher in patients with monocytosis. The 30-day mortality in patients with monocytosis was most notably influenced by a cardiological diagnosis (odds ratio 3.91).An increased monocyte count predicts adverse outcome in patients admitted to the emergency department. Mechanistic studies will be necessary to specify the potentially detrimental role of monocytosis in critical illness.
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Affiliation(s)
- Mathias Hensel
- Department of Rheumatology, University Hospital Basel, Basel
| | - Lena Grädel
- Department Internal Medicine, Kantonsspital Aarau, Aarau
| | - Alexander Kutz
- Department Internal Medicine, Kantonsspital Aarau, Aarau
| | | | - Andreas Huber
- Department Internal Medicine, Kantonsspital Aarau, Aarau
| | - Beat Mueller
- Department Internal Medicine, Kantonsspital Aarau, Aarau
| | | | - Thomas Hügle
- Department of Rheumatology, University Hospital Lausann (CHUV), Lausann, Switzerland
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5
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Mewhort HEM, Lipon BD, Svystonyuk DA, Teng G, Guzzardi DG, Silva C, Yong VW, Fedak PWM. Monocytes increase human cardiac myofibroblast-mediated extracellular matrix remodeling through TGF-β1. Am J Physiol Heart Circ Physiol 2016; 310:H716-24. [PMID: 26801303 DOI: 10.1152/ajpheart.00309.2015] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 01/18/2016] [Indexed: 01/12/2023]
Abstract
Following myocardial infarction (MI), cardiac myofibroblasts remodel the extracellular matrix (ECM), preventing mechanical complications. However, prolonged myofibroblast activity leads to dysregulation of the ECM, maladaptive remodeling, fibrosis, and heart failure (HF). Chronic inflammation is believed to drive persistent myofibroblast activity; however, the mechanisms are unclear. We assessed the influence of peripheral blood monocytes on human cardiac myofibroblast activity in a three-dimensional (3D) ECM microenvironment. Human cardiac myofibroblasts isolated from surgical biopsies of the right atrium and left ventricle were seeded into 3D collagen matrices. Peripheral blood monocytes were isolated from healthy human donors and cocultured with myofibroblasts. Monocytes increased myofibroblast activity measured by collagen gel contraction (baseline: 57.6 ± 5.9% vs. coculture: 65.2 ± 7.1% contraction; P < 0.01) and increased local ECM remodeling quantified by confocal microscopy. Under coculture conditions that allow indirect cellular interaction via paracrine factors but prevent direct cell-cell contact, monocytes had minimal effects on myofibroblast activity (17.9 ± 11.1% vs. 6.4 ± 7.0% increase, respectively; P < 0.01). When cells were cultured under direct contact conditions, multiplex analysis of the coculture media revealed an increase in the paracrine factors TGF-β1 and matrix metalloproteinase 9 compared with baseline (122.9 ± 10.1 pg/ml and 3,496.0 ± 190.4 pg/ml, respectively, vs. 21.5 ± 16.3 pg/ml and 183.3 ± 43.9 pg/ml; P < 0.001). TGF-β blockade abolished the monocyte-induced increase in cardiac myofibroblast activity. These data suggest that direct cell-cell interaction between monocytes and cardiac myofibroblasts stimulates TGF-β-mediated myofibroblast activity and increases remodeling of local matrix. Peripheral blood monocyte interaction with human cardiac myofibroblasts stimulates myofibroblast activity through release of TGF-β1. These data implicate inflammation as a potential driver of cardiac fibrosis.
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Affiliation(s)
- Holly E M Mewhort
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada; and
| | - Brodie D Lipon
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada; and
| | - Daniyil A Svystonyuk
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada; and
| | - Guoqi Teng
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada; and
| | - David G Guzzardi
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada; and
| | - Claudia Silva
- Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - V Wee Yong
- Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Paul W M Fedak
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada; and
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6
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Biwer LA, D'souza KM, Abidali A, Tu D, Siniard AL, DeBoth M, Huentelman M, Hale TM. Time course of cardiac inflammation during nitric oxide synthase inhibition in SHR: impact of prior transient ACE inhibition. Hypertens Res 2015; 39:8-18. [PMID: 26490086 DOI: 10.1038/hr.2015.107] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 07/13/2015] [Accepted: 08/25/2015] [Indexed: 11/09/2022]
Abstract
We have previously demonstrated that angiotensin-converting enzyme (ACE) inhibition with enalapril produces persistent effects that protect against future nitric oxide synthase (NOS) inhibitor (L-arginine methyl ester, L-NAME)-induced cardiac dysfunction and outer wall collagen deposition in spontaneously hypertensive rats (SHR). In the present study, we dissect the cytokine/chemokine release profile during NOS inhibition, its correlation to pathological cardiac remodeling and the impact of transient ACE inhibition on these effects. Adult male SHR were treated with enalapril (E+L) or tap water (C+L) for 2 weeks followed by a 2-week washout period. Rats were then subjected to 0, 3, 7 or 10 days of L-NAME treatment. The temporal response to NOS inhibition was evaluated by measuring arterial pressure, cardiac remodeling and cytokine/chemokine levels. L-NAME equivalently increased blood pressure and myocardial and vascular injury in C+L and E+L rats. However, pulse pressure (PP) was only transiently altered in C+L rats. The levels of several inflammatory mediators were increased during L-NAME treatment. However, interleukin-6 (IL-6) and IL-10 and monocyte chemoattractant protein-1 were uniquely increased in C+L hearts; whereas IL-4 and fractalkine were only elevated in E+L hearts. By days 7 and 10 of L-NAME treatment, there was a significant increase in the cardiac density of macrophages and proliferating cells, respectively only in C+L rats. Although myocardial injury was similar in both treatment groups, PP was not changed and there was a distinct cardiac chemokine/cytokine signature in rats previously treated with enalapril that may be related to the lack of proliferative response and macrophage infiltration in these hearts.
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Affiliation(s)
- Lauren A Biwer
- Department of Basic Medical Sciences, University of Arizona, College of Medicine-Phoenix, Phoenix AZ, USA
| | - Karen M D'souza
- Department of Basic Medical Sciences, University of Arizona, College of Medicine-Phoenix, Phoenix AZ, USA
| | - Ali Abidali
- Department of Basic Medical Sciences, University of Arizona, College of Medicine-Phoenix, Phoenix AZ, USA
| | - Danni Tu
- Department of Basic Medical Sciences, University of Arizona, College of Medicine-Phoenix, Phoenix AZ, USA
| | - Ashley L Siniard
- Neurogenomics Division, The Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Matthew DeBoth
- Neurogenomics Division, The Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Matthew Huentelman
- Neurogenomics Division, The Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Taben M Hale
- Department of Basic Medical Sciences, University of Arizona, College of Medicine-Phoenix, Phoenix AZ, USA
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7
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Systemic inflammatory response following acute myocardial infarction. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2015; 12:305-12. [PMID: 26089856 PMCID: PMC4460175 DOI: 10.11909/j.issn.1671-5411.2015.03.020] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 03/02/2015] [Accepted: 04/11/2015] [Indexed: 12/31/2022]
Abstract
Acute cardiomyocyte necrosis in the infarcted heart generates damage-associated molecular patterns, activating complement and toll-like receptor/interleukin-1 signaling, and triggering an intense inflammatory response. Inflammasomes also recognize danger signals and mediate sterile inflammatory response following acute myocardial infarction (AMI). Inflammatory response serves to repair the heart, but excessive inflammation leads to adverse left ventricular remodeling and heart failure. In addition to local inflammation, profound systemic inflammation response has been documented in patients with AMI, which includes elevation of circulating inflammatory cytokines, chemokines and cell adhesion molecules, and activation of peripheral leukocytes and platelets. The excessive inflammatory response could be caused by a deregulated immune system. AMI is also associated with bone marrow activation and spleen monocytopoiesis, which sustains a continuous supply of monocytes at the site of inflammation. Accumulating evidence has shown that systemic inflammation aggravates atherosclerosis and markers for systemic inflammation are predictors of adverse clinical outcomes (such as death, recurrent myocardial infarction, and heart failure) in patients with AMI.
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8
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Abstract
The important role of the immune system and inflammation in the pathophysiology of heart failure (HF) is becoming increasingly appreciated. We have reviewed the prognostic significance of under-recognized aspects of the leukocyte differential in HF, including lymphocytes, monocytes, eosinophils and mast cells. Studies to date evaluating lymphocyte counts in both chronic and hospitalized HF patients have consistently shown worse prognosis associated with low lymphocyte counts, despite widely heterogeneous study designs. Limited data suggest elevations in monocyte-derived cytokines and serum monocyte count may be predictive of poor outcomes in HF. Further data are required to better define the relationship between eosinophils, mast cells and HF. Leukocyte differentials are widely available, simple, inexpensive and appear to have independent prognostic significance, beyond traditional risk factors. Enhanced sympathetic activation and increased circulating cytokine levels (particularly tumor necrosis factor) have been implicated in the variability of leukocyte subpopulations. To date, immune-modulators targeting these mediators have been largely unsuccessful in improving cardiovascular outcomes in HF. Given the potential role of the immunological axis in HF, there may be an unmet need for novel therapeutic agents that can safely and effectively ameliorate these leukocyte derangements and perhaps improve the unacceptably high event rate in this population. Variations in leukocyte differentials may identify a high-risk subset of patients that may benefit from tailored immune therapies.
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9
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Lapraz JC, Hedayat KM, Pauly P. Endobiogeny: a global approach to systems biology (part 2 of 2). Glob Adv Health Med 2014; 2:32-44. [PMID: 24416662 PMCID: PMC3833520 DOI: 10.7453/gahmj.2013.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
ENDOBIOGENY AND THE BIOLOGY OF FUNCTIONS ARE BASED ON FOUR SCIENTIFIC CONCEPTS THAT ARE KNOWN AND GENERALLY ACCEPTED: (1) human physiology is complex and multifactorial and exhibits the properties of a system; (2) the endocrine system manages metabolism, which is the basis of the continuity of life; (3) the metabolic activity managed by the endocrine system results in the output of biomarkers that reflect the functional achievement of specific aspects of metabolism; and (4) when biomarkers are related to each other in ratios, it contextualizes one type of function relative to another to which is it linked anatomically, sequentially, chronologically, biochemically, etc.
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Affiliation(s)
- Jean-Claude Lapraz
- Société internationale de médecine endobiogénique et de physiologie intégrative, Paris, France
| | - Kamyar M Hedayat
- American Society of Endobiogenic Medicine and Integrative physiology, San Diego, California, United States
| | - Patrice Pauly
- Société internationale de médecine endobiogénique et de physiologie intégrative, Paris, France
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10
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Tanaka A, Ito Y, Tanaka T, Satozaki S, Hayashi F, Tsuda I. Blood monocyte count may be a predictor of vascular access failure in hemodialysis patients. Ther Apher Dial 2013; 17:620-4. [PMID: 24330557 DOI: 10.1111/1744-9987.12021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
It has been reported that an increase in the counts of white blood cells (WBC) and their subpopulations is an independent predictor of atherosclerotic events and mortality. On the other hand, vascular access (VA) stenosis is caused by a progressive development of neointimal hyperplasia. We examined the relationship between VA failure and counts of peripheral WBC and their subpopulations in hemodialysis (HD) patients. The study population consisted of 82 patients undergoing regular HD. Twenty-two patients, who were unstable, were excluded from the study. After one year, we examined the relationship between VA failure and the counts of peripheral WBC and their subpopulations. In the follow-up period, 21 patients had complicated VA failure. The counts of WBC, neutrophils, lymphocytes, eosinophils, and basophils did not show a significant difference, but a monocyte count of ≥ 400/μL was shown to indicate a high probability of VA failure. Logistic regression analysis revealed that monocyte count was an independent risk factor of VA failure. The peripheral blood monocyte count may be a predictor of VA failure in HD patients.
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Affiliation(s)
- Akihito Tanaka
- Dialysis Center, Namikikai Namiki Clinic, Nagoya City, Japan
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11
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Selejan S, Poss J, Walter F, Hohl M, Kaiser R, Kazakov A, Bohm M, Link A. Ischaemia-induced up-regulation of Toll-like receptor 2 in circulating monocytes in cardiogenic shock. Eur Heart J 2011; 33:1085-94. [DOI: 10.1093/eurheartj/ehr377] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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12
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Antibody to Granulocyte Macrophage Colony–stimulating Factor Reduces the Number of Activated Tissue Macrophages and Improves Left Ventricular Function After Myocardial Infarction in a Rat Coronary Artery Ligation Model. J Cardiovasc Pharmacol 2011; 57:568-74. [DOI: 10.1097/fjc.0b013e318213258b] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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13
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Aoki S, Nakagomi A, Asai K, Takano H, Yasutake M, Seino Y, Mizuno K. Elevated peripheral blood mononuclear cell count is an independent predictor of left ventricular remodeling in patients with acute myocardial infarction. J Cardiol 2010; 57:202-7. [PMID: 21168993 DOI: 10.1016/j.jjcc.2010.10.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Revised: 10/01/2010] [Accepted: 10/29/2010] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Peripheral blood mononuclear cells (PBMCs) increase after acute myocardial infarction (AMI) and infiltrate to the infarct region. However, its impact on left ventricular (LV) remodeling remains unclear. The purpose of the present study was to clarify whether elevated PBMC count contributed to LV remodeling in patients with AMI. SUBJECTS AND METHODS A total of 131 patients with AMI were recruited. White blood cell (WBC), monocyte, and lymphocyte counts were measured at presentation and every 24h for five days after presentation. The correlation between PBMC count and LV remodeling was evaluated. LV remodeling was defined as an increase of LV end-diastolic volume index ≥ 10% at the 6-month follow-up left ventriculography. RESULTS Forty-eight patients had LV remodeling. Peak WBC (p=0.008), peak monocyte (p=0.001), and peak PBMC (p<0.001) counts were significantly greater in patients with LV remodeling than those without remodeling. Multivariate analysis revealed the peak PBMC count ≥ 3600/mm(3) was an independent predictor of LV remodeling [relative risk (RR) 3.243, p=0.011]. CONCLUSION Increased PBMC count is significantly correlated with LV remodeling, thus suggesting that PBMCs play a pivotal role for the development of LV remodeling after AMI.
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Affiliation(s)
- Satoshi Aoki
- The Department of Medicine, Division of Cardiology, Nippon Medical School, Tokyo, Japan.
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14
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Huang G, Zhong XN, Zhong B, Chen YQ, Liu ZZ, Su L, Ling ZY, Cao H, Yin YH. Significance of white blood cell count and its subtypes in patients with acute coronary syndrome. Eur J Clin Invest 2009; 39:348-58. [PMID: 19320909 DOI: 10.1111/j.1365-2362.2009.02107.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Inflammation plays a role in the pathogenesis of coronary atherosclerosis. MATERIALS AND METHODS Six hundred twenty-three patients with acute coronary syndrome (ACS) referred for coronary angiography for the first time in our hospital were enrolled in this study. White blood cell and its subtypes were measured on admission. The study population was divided into three groups based on total white blood cell count and followed up. Clinical end points were major adverse cardiac events (MACEs), including cardiogenic death, stroke, heart failure, non-fatal myocardial infarction, rehospitalization for angina pectoris. RESULTS The median age was 68 years (range 31-92) and 64.2% of the patients were men. The median white blood cell count was 6.48 x 10(9 )L(-1) (range 2.34-27.10 x 10(9 )L(-1)). The median follow-up duration was 21 months (range 1-116) and MACEs occurred in 167 patients. The multivariable Cox proportional hazards regression model revealed that neutrophil count [Relative risk = 1.098, 95% Confidence interval (CI): 1.010-1.193, P = 0.029) was a risk factor for MACEs. The logistic regression model revealed that lymphocyte count [Odds ratio (OR) = 1.075, 95% CI: 1.012-1.142, P = 0.018] and monocyte count (OR = 8.578, 95% CI: 2.687-27.381, P < 0.001) were predictive of stenosis >or= 75%; Neutrophil proportion (OR = 1.060, 95% CI: 1.007-1.115, P = 0.026), monocyte count (OR = 12.370, 95% CI: 1.298-118.761, P = 0.029) were predictive of the presence of multivessel disease. Kaplan-Meier analysis of short-term and long-term cumulative survival showed no significant statistical differences among three groups. CONCLUSIONS Neutrophil count adds prognostic information to MACEs in ACS. Monocyte count and lymphocyte count are predictive of severity of coronary atherosclerosis.
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Affiliation(s)
- G Huang
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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15
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Takahashi T, Hiasa Y, Ohara Y, Miyazaki SI, Ogura R, Suzuki N, Hosokawa S, Kishi K, Ohtani R. Relationship of admission neutrophil count to microvascular injury, left ventricular dilation, and long-term outcome in patients treated with primary angioplasty for acute myocardial infarction. Circ J 2008; 72:867-72. [PMID: 18503208 DOI: 10.1253/circj.72.867] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The relationship of admission neutrophil count to the degree of microvascular injury, left ventricular (LV) volume, and long-term outcome after acute myocardial infarction (AMI) was examined in the present study. METHODS AND RESULTS The study group comprised 228 consecutive patients with a first anterior wall AMI who underwent primary angioplasty within 12 h of onset. The degree of microvascular injury was evaluated by Doppler guidewire. Adverse cardiac events were recorded during an average follow-up of 52+/-28 months. Using a receiver-operating characteristic analysis, a neutrophil count >or=7,260 cells/mm(3) was the best predictor of future cardiac events. By regression analysis, the neutrophil count significantly correlated with diastolic deceleration time (r=-0.40, p<0.0001), coronary flow reserve (r=-0.43, p<0.0001), and LV end-diastolic volume at 4 weeks (r=0.32, p<0.0001). Kaplan-Meier survival analysis showed a higher incidence of adverse cardiac events in patients with a high neutrophil count (p=0.002). By multivariate analysis, a neutrophil count >or=7,260 cells/mm(3) was an independent predictor of long-term adverse cardiac events (odds ratio 3.8, p=0.002). CONCLUSION Neutrophilia on admission is associated with impaired microvascular perfusion, LV dilation, and long-term adverse cardiac events in patients treated with primary angioplasty for AMI.
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Affiliation(s)
- Takefumi Takahashi
- Department of Cardiology, Tokushima Red Cross Hospital, 130 Irinoguchi, Komatsushimacho, Komatsushima 773-8502, Japan.
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