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Nakashima N, Tahara N, Sugiyama Y, Bekki M, Maeda-Ogata S, Honda A, Goto C, Tanaka S, Fukumoto Y. Compression Stockings Improve Lower Legs Symptom in Patients with Pulmonary Artery Hypertension Treated by Pulmonary Vasodilators-A Pilot Study. J Clin Med 2023; 12:jcm12072484. [PMID: 37048566 PMCID: PMC10095423 DOI: 10.3390/jcm12072484] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/12/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
Pulmonary vasodilators have improved pulmonary arterial hypertension (PAH) symptoms and prognosis; however, the drugs cause some side effects, including lower legs pain, which impair quality of life (QOL). The present study examined if compression stockings improved lower extremity symptoms and QOL caused by pulmonary vasodilators in PAH patients. We retrospectively enrolled consecutively ten patients with PAH treated by pulmonary vasodilators, who were regularly followed in Kurume University Hospital from January 2022 to June 2022. Oral questionnaire surveys, the Numeric Rating Scale for Pain (NRS) and the Pain Disability Assessment Scale (PDAS), were conducted regarding lower extremity symptoms before wearing elastic stockings and one month later, to evaluate how the lower extremity symptoms affected daily life. All ten patients were female, with a mean age of 50.2 ± 11.5 years, out of whom intravenous prostacyclin analogue (PGI2) was administered in five patients. In no intravenous PGI2 group, NRS score was significantly improved from 4.6 ± 2.3 to 2.8 ± 1.2 (p = 0.037), while from 9.4 ± 1.2 to 5.4 ± 1.6 (p = 0.002) in intravenous PGI2 group. PDAS score was also significantly improved [no intravenous PGI2 group; 18.0 (15.0-24.0) to 15.0 (10.0-19.0), intravenous PGI2 group; 25.0 (17.0-37.0) to 17.0 (5.0-27.0)]. Lower extremity symptoms in patients using pulmonary vasodilators were improved by wearing compression stockings.
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Affiliation(s)
- Naoko Nakashima
- Nursing Department, Kurume University Hospital, Kurume 830-0011, Japan
| | - Nobuhiro Tahara
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Yoichi Sugiyama
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Munehisa Bekki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Shoko Maeda-Ogata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Akihiro Honda
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Chidu Goto
- Nursing Department, Kurume University Hospital, Kurume 830-0011, Japan
| | - Setsuko Tanaka
- Nursing Department, Kurume University Hospital, Kurume 830-0011, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan
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Evaluating the efficacy and safety of rivaroxaban as a warfarin alternative in chronic thromboembolic pulmonary hypertension patients undergoing pulmonary endarterectomy: A randomized clinical trial. Rev Port Cardiol 2023; 42:139-144. [PMID: 36228832 DOI: 10.1016/j.repc.2021.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND AND AIM Chronic thromboembolic pulmonary hypertension (CTEPH) is caused by the obstruction of the main pulmonary artery due to thrombosis and vascular remodeling. Regarding the need for anticoagulant therapy in CTEPH patients, this study aimed to compare rivaroxaban with warfarin in terms of its efficacy and safety in patients undergoing endarterectomy surgery. METHODS The study was a parallel clinical trial in patients who underwent endarterectomy following CTEPH. A total of 96 patients were randomly selected and assigned to two groups: warfarin-treated (control) and rivaroxaban-treated (intervention). Patients were clinically assessed for re-thrombosis, re-admission, bleeding, and mortality in the first, third, and sixth months after surgery. RESULTS There was no significant difference in the occurrence of thrombosis between the two groups within the first, third-, and sixth-months post-surgery (p=0.52, 1, 0.38 respectively). Moreover, the mortality rate (p=0.9), bleeding rate (p=0.06), and re-admission rate (p=0.15) showed no significant differences between the two groups. CONCLUSION Rivaroxaban may be as effective as warfarin in treating CTEPH patients after endarterectomy in the short term and can be used as an anticoagulant in these patients. However, studies with long-term follow-ups are needed to consolidate the strategy of treating these patients with rivaroxaban.
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Ding XF, Liang HY, Yuan B, Li LF, Wang T, Kan QC, Wang LX, Sun TW. Efficacy of stem cell therapy for pulmonary arterial hypertension: a systematic review and meta-analysis of preclinical studies. Stem Cell Res Ther 2019; 10:55. [PMID: 30760312 PMCID: PMC6374914 DOI: 10.1186/s13287-019-1162-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/06/2019] [Accepted: 02/04/2019] [Indexed: 12/19/2022] Open
Abstract
Background Despite significant progress in drug treatment, the prognosis of patients with advanced pulmonary arterial hypertension (PAH) remains extremely poor. Many preclinical studies have reported the efficacy of stem cell (SC) therapy for PAH; however, this approach remains controversial. The aim of this systematic review and meta-analysis is to assess the potential efficacy of SC therapy for PAH. Methods The Medline, EMBASE, Cochrane Library, and Web of Science databases were searched from inception to August 12, 2018. Preclinical studies that evaluated the use of SC therapy for PAH were included. The primary outcome was pulmonary haemodynamics, as assessed by measurement of the right ventricular systolic pressure (RVSP), mean pulmonary arterial pressure (mPAP), and/or mean right ventricle pressure (mRVP). The secondary outcomes included the weight ratio of the right ventricle to the left ventricle plus septum (RV/LV+S), the right ventricle to body weight ratio (RV/BW), the percentage of pulmonary arteriole area index (WA), and/or the percentage of medial wall thickness of the pulmonary arteriole (WT). The quality of outcomes was evaluated using the SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE) bias risk tool. The inverse-variance method with random-effects modelling was used to calculate pooled weighted mean differences (WMDs) and 95% CIs. Statistical analysis was performed with STATA 14.0. Results Twenty-eight eligible articles (722 animals) were included. SC therapy reduced the pooled WMDs (95% CIs) of RVSP, mPAP, mRVP, RV/LV+S, RV/BW, WA, and WT for animals with PAH, with values of − 14.12 (− 14.63, − 13.61), − 11.86 (− 12.35, − 11.36), − 17.33 (− 18.10, − 16.56), − 0.10 (− 0.10, − 0.09), 0.23 (0.21, 0.24), − 13.66 (− 15.71, − 11.62), and − 7.96 (− 7.99, − 7.93), respectively. Conclusions SC therapy is effective for PAH in preclinical studies. These results may help to standardise preclinical animal studies and provide a theoretical basis for clinical trial design in the future. Systematic review registration PROSPERO (http://www.crd.york.ac.uk/PROSPERO). Electronic supplementary material The online version of this article (10.1186/s13287-019-1162-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xian-Fei Ding
- General ICU, Henan Key Laboratory of Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Huo-Yan Liang
- General ICU, Henan Key Laboratory of Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Bo Yuan
- General ICU, Henan Key Laboratory of Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Li-Feng Li
- Biotherapy Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Tian Wang
- Biotherapy Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Quan-Cheng Kan
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Le-Xin Wang
- School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW, 2650, Australia
| | - Tong-Wen Sun
- General ICU, Henan Key Laboratory of Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
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4
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Zhu Y, Li F, Shi W, Zhai C, Wang J, Yan X, Wang Q, Zhang Q, Yang L, Gao L, Li M. COP9 signalosome subunit 6 mediates PDGF -induced pulmonary arterial smooth muscle cells proliferation. Exp Cell Res 2018; 371:379-388. [PMID: 30180991 DOI: 10.1016/j.yexcr.2018.08.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 08/08/2018] [Accepted: 08/27/2018] [Indexed: 12/27/2022]
Abstract
Up-regulation of mammalian COP9 signalosome subunit 6 (CSN6) and consequent reduction of SCF ubiquitin ligase substrate receptor β-transduction repeat-containing protein (β-TrCP) have been shown to be associated with cancer cells proliferation. However, it is unclear whether CSN6 and β-TrCP are also involved in PDGF-induced pulmonary arterial smooth muscle cells (PASMCs) proliferation. This study aims to address this issue and further explore its potential mechanisms. Our results indicated that PDGF phosphorylated Akt, stimulated PASMCs proliferation; while inhibition of PDGF receptor (PDGFR) by imatinib prevented these effects. PDGF further up-regulated CSN6 protein expression, this was accompanied with β-TrCP reduction and increase of Cdc25A. Inhibition of PDGFR/PI3K/Akt signaling pathway reversed PDGF-induced such changes and cell proliferation. Prior transfection of CSN6 siRNA blocked PDGF-induced β-TrCP down-regulation, Cdc25A up-regulation and cell proliferation. Furthermore, pre-treatment of cells with MG-132 also abolished PDGF-induced β-TrCP reduction, Cdc25A elevation and cell proliferation. In addition, pre-depletion of Cdc25A by siRNA transfection suppressed PDGF-induced PASMCs proliferation. Taken together, our study indicates that up-regulation of CSN6 by PDGFR/PI3K/Akt signaling pathway decreases β-TrCP by increasing its ubiquitinated degradation, and thereby increases the expression of Cdc25A, which promotes PDGF-induced PASMCs proliferation.
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Affiliation(s)
- Yanting Zhu
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Fangwei Li
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Wenhua Shi
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Cui Zhai
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Jian Wang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Xin Yan
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Qingting Wang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Qianqian Zhang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Lan Yang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Li Gao
- Division of Allergy and Clinical Immunology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
| | - Manxiang Li
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China.
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Higo K, Kubota K, Miyanaga S, Miyata M, Nakajo M, Jinguji M, Ohishi M. Impairment of Iodine-123-Metaiodobenzylguanidine (<sup>123</sup>I-MIBG) Uptake in Patients with Pulmonary Artery Hypertension. Int Heart J 2018; 59:112-119. [DOI: 10.1536/ihj.16-629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Kenjuro Higo
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Kayoko Kubota
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Sunao Miyanaga
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Masaaki Miyata
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Masatoyo Nakajo
- Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Megumi Jinguji
- Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
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Chibana H, Tahara N, Itaya N, Ishimatsu T, Sasaki M, Sasaki M, Nakayoshi T, Ohtsuka M, Yokoyama S, Sasaki KI, Ueno T, Fukumoto Y. Pulmonary artery dysfunction in chronic thromboembolic pulmonary hypertension. IJC HEART & VASCULATURE 2017; 17:30-32. [PMID: 29159269 PMCID: PMC5683704 DOI: 10.1016/j.ijcha.2017.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 08/25/2017] [Accepted: 09/27/2017] [Indexed: 11/17/2022]
Abstract
Background Unresolved thromboemboli in the pulmonary arteries (PA) is known to cause chronic thromboembolic pulmonary hypertension (CTEPH). However, it remains unknown if vascular dysfunction in pulmonary arteries exists in patients with CTEPH. Methods and results We enrolled 7 female patients with CTEPH in this study, who have stable pulmonary hemodynamics after balloon pulmonary angioplasty (age; 73.6 ± 3.0 years old, mean right atrial pressure; 4.1 ± 0.4 mm Hg, mean pulmonary arterial pressure; 29.4 ± 2.7, mean pulmonary artery wedge pressure; 8.1 ± 1.2, pulmonary vascular resistance; 397.3 ± 51.7 dynes, cardiac index; 3.1 ± 0.2 L/min/m2). Pulmonary artery vascular function was evaluated by measuring pulmonary artery vasomotion in response to acetylcholine (Ach) at 10-month follow-up after balloon pulmonary angioplasty. All pulmonary vasoactive drugs were discontinued on the day of the procedures. The endothelium-dependent vasomotor response was evaluated by intra-pulmonary artery infusion of Ach at the dose of 10− 8 mol/l, and the vaso-spastic response was at 10− 6 mol/l. We evaluated vasomotor responses at the same segment in each patient, by measuring % changes of luminal area detected by quantitative pulmonary arterial optical frequency-domain imaging (OFDI), where OFDI catheter was fixed during the procedure. Endothelial dysfunction was observed at the dose of Ach at 10− 8 mol/l and vasoconstriction was also confirmed at the dose of Ach at 10− 6 mol/l in the diseased pulmonary arteries in CTEPH. Conclusions These results indicated that the pulmonary artery dysfunction exists in patients with CTEPH, which may be involved in the pathogenesis and progression of CTEPH.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Yoshihiro Fukumoto
- Corresponding author at: Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan.Department of Internal MedicineDivision of Cardiovascular MedicineKurume University School of Medicine67 Asahi-machiKurume830-0011Japan
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7
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Optical coherence tomography and confocal laser endomicroscopy in pulmonary diseases. Curr Opin Pulm Med 2017; 23:275-283. [DOI: 10.1097/mcp.0000000000000375] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Hirashiki A, Adachi S, Nakano Y, Kamimura Y, Shimokata S, Takeshita K, Shimizu A, Toba K, Murohara T, Kondo T. Circulatory power and ventilatory power over time under goal-oriented sequential combination therapy for pulmonary arterial hypertension. Pulm Circ 2017; 7:448-454. [PMID: 28597753 PMCID: PMC5467935 DOI: 10.1177/2045893217703954] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Many therapeutic options are available for patients with pulmonary arterial hypertension (PAH). However, little is known about the effects of sequential combination therapy on exercise capacity. Here we monitored exercise capacity by cardiopulmonary exercise testing (CPX) and observed the benefit of using a peak VO2 cutoff of 15 mL/kg/min to guide combination therapy. Thirty patients newly diagnosed with PAH were treated with goal-oriented sequential combination therapy. Endothelin receptor antagonists (ERA) were the first-line treatment, with phosphodiesterase type 5 inhibitors (PDE-5i) as the preferred combination partner. The patients underwent cardiac catheterization at baseline and after 12 months and CPX at baseline and after three, six, and 12 months. Circulatory power (CP) was defined as the product of peak O2 uptake and peak systolic blood pressure (SBP); ventilatory power (VP) was defined as peak SBP divided by the minute ventilation–CO2 production slope. After 12 months, ERA had been administered to 100% of the study patients and PDE-5i to 82%. Mean CP at baseline and after three, six, and 12 months was 1807, 2063, 2248, and 2245 mmHg·min/mL/kg, respectively, and mean VP was 2.93, 3.53, 4.16, and 3.68 mmHg, respectively. CP was greater after 6 months than at baseline (P = 0.047); VP was greater after three months than at baseline (P = 0.019) and further improved at six months compared with three months (P = 0.040). Therefore, repeated CPX assessment, including measurement of CP and VP, can provide useful information regarding the efficacy of goal-oriented treatment for PAH.
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Affiliation(s)
- Akihiro Hirashiki
- 1 Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,2 Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Shiro Adachi
- 3 Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshihisa Nakano
- 1 Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshihiro Kamimura
- 1 Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shigetake Shimokata
- 1 Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kyosuke Takeshita
- 1 Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Atsuya Shimizu
- 2 Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Toba
- 2 Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Toyoaki Murohara
- 1 Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takahisa Kondo
- 3 Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Lee JC, Cha CI, Kim D, Choe SY. Therapeutic effects of umbilical cord blood derived mesenchymal stem cell-conditioned medium on pulmonary arterial hypertension in rats. J ANAT SOC INDIA 2016. [DOI: 10.1016/j.jasi.2016.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Yaoita N, Satoh K, Satoh T, Sugimura K, Tatebe S, Yamamoto S, Aoki T, Miura M, Miyata S, Kawamura T, Horiuchi H, Fukumoto Y, Shimokawa H. Thrombin-Activatable Fibrinolysis Inhibitor in Chronic Thromboembolic Pulmonary Hypertension. Arterioscler Thromb Vasc Biol 2016; 36:1293-301. [DOI: 10.1161/atvbaha.115.306845] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 04/08/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Nobuhiro Yaoita
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (N.Y., K. Satoh, T.S., K. Sugimura, S.T., S.Y., T.A., M.M., S.M., Y.F., H.S.), Clinical Pharmaceutics educational Center, Nihon Pharmaceutical University, Saitama, Japan (T.K.); and Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan (H.H.)
| | - Kimio Satoh
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (N.Y., K. Satoh, T.S., K. Sugimura, S.T., S.Y., T.A., M.M., S.M., Y.F., H.S.), Clinical Pharmaceutics educational Center, Nihon Pharmaceutical University, Saitama, Japan (T.K.); and Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan (H.H.)
| | - Taijyu Satoh
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (N.Y., K. Satoh, T.S., K. Sugimura, S.T., S.Y., T.A., M.M., S.M., Y.F., H.S.), Clinical Pharmaceutics educational Center, Nihon Pharmaceutical University, Saitama, Japan (T.K.); and Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan (H.H.)
| | - Koichiro Sugimura
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (N.Y., K. Satoh, T.S., K. Sugimura, S.T., S.Y., T.A., M.M., S.M., Y.F., H.S.), Clinical Pharmaceutics educational Center, Nihon Pharmaceutical University, Saitama, Japan (T.K.); and Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan (H.H.)
| | - Shunsuke Tatebe
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (N.Y., K. Satoh, T.S., K. Sugimura, S.T., S.Y., T.A., M.M., S.M., Y.F., H.S.), Clinical Pharmaceutics educational Center, Nihon Pharmaceutical University, Saitama, Japan (T.K.); and Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan (H.H.)
| | - Saori Yamamoto
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (N.Y., K. Satoh, T.S., K. Sugimura, S.T., S.Y., T.A., M.M., S.M., Y.F., H.S.), Clinical Pharmaceutics educational Center, Nihon Pharmaceutical University, Saitama, Japan (T.K.); and Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan (H.H.)
| | - Tatsuo Aoki
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (N.Y., K. Satoh, T.S., K. Sugimura, S.T., S.Y., T.A., M.M., S.M., Y.F., H.S.), Clinical Pharmaceutics educational Center, Nihon Pharmaceutical University, Saitama, Japan (T.K.); and Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan (H.H.)
| | - Masanobu Miura
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (N.Y., K. Satoh, T.S., K. Sugimura, S.T., S.Y., T.A., M.M., S.M., Y.F., H.S.), Clinical Pharmaceutics educational Center, Nihon Pharmaceutical University, Saitama, Japan (T.K.); and Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan (H.H.)
| | - Satoshi Miyata
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (N.Y., K. Satoh, T.S., K. Sugimura, S.T., S.Y., T.A., M.M., S.M., Y.F., H.S.), Clinical Pharmaceutics educational Center, Nihon Pharmaceutical University, Saitama, Japan (T.K.); and Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan (H.H.)
| | - Takeshi Kawamura
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (N.Y., K. Satoh, T.S., K. Sugimura, S.T., S.Y., T.A., M.M., S.M., Y.F., H.S.), Clinical Pharmaceutics educational Center, Nihon Pharmaceutical University, Saitama, Japan (T.K.); and Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan (H.H.)
| | - Hisanori Horiuchi
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (N.Y., K. Satoh, T.S., K. Sugimura, S.T., S.Y., T.A., M.M., S.M., Y.F., H.S.), Clinical Pharmaceutics educational Center, Nihon Pharmaceutical University, Saitama, Japan (T.K.); and Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan (H.H.)
| | - Yoshihiro Fukumoto
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (N.Y., K. Satoh, T.S., K. Sugimura, S.T., S.Y., T.A., M.M., S.M., Y.F., H.S.), Clinical Pharmaceutics educational Center, Nihon Pharmaceutical University, Saitama, Japan (T.K.); and Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan (H.H.)
| | - Hiroaki Shimokawa
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (N.Y., K. Satoh, T.S., K. Sugimura, S.T., S.Y., T.A., M.M., S.M., Y.F., H.S.), Clinical Pharmaceutics educational Center, Nihon Pharmaceutical University, Saitama, Japan (T.K.); and Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan (H.H.)
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11
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Qiao F, Zou Z, Liu C, Zhu X, Wang X, Yang C, Jiang T, Chen Y. ROCK2 mediates the proliferation of pulmonary arterial endothelial cells induced by hypoxia in the development of pulmonary arterial hypertension. Exp Ther Med 2016; 11:2567-2572. [PMID: 27284349 DOI: 10.3892/etm.2016.3214] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 03/10/2016] [Indexed: 11/06/2022] Open
Abstract
It has been reported that RhoA activation and Rho-kinase (ROCK) expression are increased in chronic hypoxic lungs, and the long-term inhibition of ROCK markedly improves the survival of patients with pulmonary arterial hypertension (PAH). However, whether Rho-kinase α (ROCK2) participates in regulation of the growth of pulmonary arterial endothelial cells (PAECs) remains unknown. The aim of the present study was to investigate the effect of hypoxia on the proliferation of PAECs and the role of ROCK2 in the underlying mechanism. The results of western blotting and reverse transcription-quantitative polymerase chain reaction analysis showed that hypoxia increased the activity and expression of ROCK2 in PAECs, and the stimulating effects of hypoxia on the proliferation of PAECs were attenuated by either the ROCK inhibitor Y27632 or transfection with ROCK2 small interfering RNA. Moreover, analysis of cyclin A and cyclin D1 mRNA expression indicated that ROCK2 mediates the cell cycle progression promoted by hypoxia. These results indicate that hypoxia promotes the proliferation of pulmonary arterial endothelial cells via activation of the ROCK2 signaling pathway.
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Affiliation(s)
- Feng Qiao
- Department of Thoracic Surgery, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang 154002, P.R. China
| | - Zhitian Zou
- Department of Thoracic Surgery, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang 154002, P.R. China
| | - Chunhui Liu
- Department of Thoracic Surgery, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang 154002, P.R. China
| | - Xiaofeng Zhu
- Department of Thoracic Surgery, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang 154002, P.R. China
| | - Xiaoqiang Wang
- Department of Thoracic Surgery, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang 154002, P.R. China
| | - Chengpeng Yang
- Department of Thoracic Surgery, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang 154002, P.R. China
| | - Tengjiao Jiang
- Department of Thoracic Surgery, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang 154002, P.R. China
| | - Ying Chen
- Department of Intensive Care Unit, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang 154002, P.R. China
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12
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Song Y, Wu Y, Su X, Zhu Y, Liu L, Pan Y, Zhu B, Yang L, Gao L, Li M. Activation of AMPK inhibits PDGF-induced pulmonary arterial smooth muscle cells proliferation and its potential mechanisms. Pharmacol Res 2016; 107:117-124. [PMID: 26993101 DOI: 10.1016/j.phrs.2016.03.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 02/19/2016] [Accepted: 03/11/2016] [Indexed: 12/30/2022]
Abstract
The aims of the present study were to examine signaling mechanisms for PDGF-induced pulmonary arterial smooth muscle cells (PASMC) proliferation and to determine the effect of AMPK activation on PDGF-induced PASMC proliferation and its underlying mechanisms. PDGF activated PI3K/Akt/mTOR signaling pathway, and this in turn up-regulated Skp2 and consequently reduced p27 leading to PASMC proliferation. Prior incubation of PASMC with metformin induced a dramatic AMPK activation and significantly blocked PDGF-induced cell proliferation. PASMC lacking AMPKα2 were resistant to the inhibitory effect of metformin on PDGF-induced cell proliferation. Metformin did not affect Akt activation but blocked mTOR phosphorylation in response to PDGF; these were accompanied by the reversion of Skp2 up-regulation and p27 reduction. Our study suggests that the activation of AMPK negatively regulates mTOR activity to suppress PASMC proliferation and therefore has a potential value in the prevention and treatment of pulmonary hypertension by negatively modulating pulmonary vascular remodeling.
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Affiliation(s)
- Yang Song
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Medical College, Xian Jiaotong University, Xian, Shaanxi 710061, PR China
| | - Yuanyuan Wu
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Medical College, Xian Jiaotong University, Xian, Shaanxi 710061, PR China
| | - Xiaofan Su
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Medical College, Xian Jiaotong University, Xian, Shaanxi 710061, PR China
| | - Yanting Zhu
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Medical College, Xian Jiaotong University, Xian, Shaanxi 710061, PR China
| | - Lu Liu
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Medical College, Xian Jiaotong University, Xian, Shaanxi 710061, PR China
| | - Yilin Pan
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Medical College, Xian Jiaotong University, Xian, Shaanxi 710061, PR China
| | - Bo Zhu
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Medical College, Xian Jiaotong University, Xian, Shaanxi 710061, PR China
| | - Lan Yang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Medical College, Xian Jiaotong University, Xian, Shaanxi 710061, PR China
| | - Li Gao
- Division of Allergy and Clinical Immunology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
| | - Manxiang Li
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Medical College, Xian Jiaotong University, Xian, Shaanxi 710061, PR China.
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13
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Tatebe S, Sugimura K, Aoki T, Miura M, Nochioka K, Yaoita N, Suzuki H, Sato H, Yamamoto S, Satoh K, Fukumoto Y, Shimokawa H. Multiple Beneficial Effects of Balloon Pulmonary Angioplasty in Patients With Chronic Thromboembolic Pulmonary Hypertension. Circ J 2016; 80:980-8. [PMID: 26911363 DOI: 10.1253/circj.cj-15-1212] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Pulmonary arterial hypertension with systemic dysfunctions, including metabolic disorders and renal dysfunction, has a poor prognosis. However, it remains to be elucidated whether chronic thromboembolic pulmonary hypertension (CTEPH) is also associated with systemic dysfunctions, and if so, whether balloon pulmonary angioplasty (BPA) improves them. METHODS AND RESULTS Fifty-five consecutive patients who underwent BPA from March 2012 to December 2014 for systemic dysfunctions, including glycemic control, lipid profiles, renal and vascular function, and nutritional status were examined. The analyses were performed before and after BPA (mean, 3.5 sessions/patient) and changes in hemodynamic parameters were compared. The average follow-up period was 474±245 days. Baseline prevalence of hypertension, diabetes mellitus, dyslipidemia and advanced chronic kidney disease was 58, 7, 33 and 36%, respectively. BPA caused marked hemodynamic improvements in the CTEPH patients. Importantly, BPA also significantly improved dysglycemia (fasting blood sugar, hemoglobin A1c and homeostatic assessment model of insulin resistance), renal (creatinine and estimated glomerular filtration rate) and vascular (cardio-ankle vascular index) functions and nutritional status (albumin, cholesterols, and body mass index). Importantly, there were positive correlations between the degrees of the hemodynamic improvements and those of other improvements. CONCLUSIONS These results indicate that BPA may exert multiple beneficial effects in CTEPH patients, not only in terms of hemodynamics but also in other systemic functions, with positive correlations among them.
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Affiliation(s)
- Shunsuke Tatebe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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14
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Nishimura R, Tanabe N, Sekine A, Kasai H, Suda R, Kato F, Jujo T, Sugiura T, Shigeta A, Sakao S, Tatsumi K. Synergistic Effects of ACE Insertion/Deletion and GNB3 C825T Polymorphisms on the Efficacy of PDE-5 Inhibitor in Patients with Pulmonary Hypertension. Respiration 2016; 91:132-40. [PMID: 26821322 DOI: 10.1159/000443772] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 12/28/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The insertion/deletion (I/D) polymorphism in the angiotensin-converting enzyme gene (ACE) and the C825T polymorphism in the G-protein β3 subunit gene (GNB3) are associated with the efficacy of phosphodiesterase-5 inhibitor (PDE-5I) in erectile dysfunction. In addition, GNB3 genotypes could be associated with clinical worsening in pulmonary hypertension (PH) treated with PDE-5I. However, no studies have described the synergistic effects of gene polymorphisms on drug efficacy in patients with PH. OBJECTIVES We aimed to examine the effects of combined ACE/GNB3 polymorphisms on the efficacy of PDE-5I in patients with PH. METHODS This was a retrospective uncontrolled study. Ninety patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic PH (CTEPH) were treated with PDE-5I. Freedom from clinical worsening and pre- and post-treatment parameters, including the 6-min walk distance (6MWD) and serum brain natriuretic peptide (BNP) levels, were compared between patients with ACE/GNB3 II/TT and non-II/TT genotypes. RESULTS Time to clinical worsening was significantly longer in patients with the II/TT genotype than in those with the non-II/TT genotype (5-year freedom from clinical worsening: 100 vs. 48.8%, respectively; p = 0.018), even in patients with CTEPH alone. Post-treatment 6MWD and BNP levels in patients with the II/TT genotype tended to be better than those in patients with the non-II/TT genotype. The ACE/GNB3 genotype was a significant predictor of clinical worsening, even after adjusting for pulmonary vascular resistance and 6MWD. CONCLUSIONS ACE and GNB3 polymorphisms may synergistically influence the efficacy of PDE-5I in patients with PH.
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Affiliation(s)
- Rintaro Nishimura
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
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15
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Lee JC, Cha CI, Kim DS, Choe SY. Therapeutic Effects of Umbilical Cord Blood Derived Mesenchymal Stem Cell-Conditioned Medium on Pulmonary Arterial Hypertension in Rats. J Pathol Transl Med 2015; 49:472-80. [PMID: 26471341 PMCID: PMC4696528 DOI: 10.4132/jptm.2015.09.11] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 09/09/2015] [Indexed: 01/07/2023] Open
Abstract
Background: Human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) may have multiple therapeutic applications for cell based therapy including the treatment of pulmonary artery hypertension (PAH). As low survival rates and potential tumorigenicity of implanted cells could undermine the mesenchymal stem cell (MSC) cell-based therapy, we chose to investigate the use of conditioned medium (CM) from a culture of MSC cells as a feasible alternative. Methods: CM was prepared by culturing hUCB-MSCs in three-dimensional spheroids. In a rat model of PAH induced by monocrotaline, we infused CM or the control unconditioned culture media via the tail-vein of 6-week-old Sprague-Dawley rats. Results: Compared with the control unconditioned media, CM infusion reduced the ventricular pressure, the right ventricle/(left ventricle+interventricular septum) ratio, and maintained respiratory function in the treated animals. Also, the number of interleukin 1α (IL-1α), chemokine (C-C motif) ligand 5 (CCL5), and tissue inhibitor of metalloproteinase 1 (TIMP-1)–positive cells increased in lung samples and the number of terminal deoxynucleotidyl transferase–mediated deoxyuridine triphosphate nick-end labeling technique (TUNEL)–positive cells decreased significantly in the CM treated animals. Conclusions: From our in vivo data in the rat model, the observed decreases in the TUNEL staining suggest a potential therapeutic benefit of the CM in ameliorating PAH-mediated lung tissue damage. Increased IL-1α, CCL5, and TIMP-1 levels may play important roles in this regard.
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Affiliation(s)
- Jae Chul Lee
- Department of Biology, School of Life Sciences, Chungbuk National University, Cheongju, Korea.,Department of Surgery, Brain Korea 21 PLUS Project for Medical Sciences and HBP Surgery and Liver Transplantation, Korea University College of Medicine, Seoul, Korea.,Department of Anatomy, Seoul National University College of Medicine, Seoul, Korea
| | - Choong Ik Cha
- Department of Anatomy, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Sik Kim
- Department of Surgery, Brain Korea 21 PLUS Project for Medical Sciences and HBP Surgery and Liver Transplantation, Korea University College of Medicine, Seoul, Korea
| | - Soo Young Choe
- Department of Biology, School of Life Sciences, Chungbuk National University, Cheongju, Korea
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16
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Androulakis E, Lioudaki E, Christophides T, Ahmad M, Fayed H, Laskar N, Schreiber B. Chronic thromboembolic pulmonary arterial hypertension: a review of the literature and novel therapeutic approaches. Expert Rev Respir Med 2015; 9:351-9. [PMID: 25974147 DOI: 10.1586/17476348.2015.1046843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Chronic thromboembolic pulmonary hypertension is defined as pulmonary hypertension (PH) caused by single or recurrent pulmonary emboli and is characterized by chronic obstruction of the pulmonary arteries leading to increased vascular resistance and PH. Also, progressive remodeling may occur in occluded and nonoccluded territories. Better understanding of the underlying mechanisms and risk factors could improve diagnosis and allow appropriate interventions. Pulmonary endarterectomy is an established approach and is considered the definitive treatment for chronic PH, resulting from thromboembolic disease. Furthermore, percutaneous transluminal pulmonary angioplasty is technically feasible, especially for those with peripheral-type of the disease. In addition, several agents, including prostanoids, endothelin receptor antagonists and phosphodiesterase type-5 inhibitors, have been tested in selected patients yielding promising results. Several novel agents are under investigation, and extensive research is currently in progress aiming to resolve uncertainties in the understanding and treatment of the disease.
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Affiliation(s)
- Emmanuel Androulakis
- Department of Cardiology, Royal Free Hospital, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, London, UK
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17
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Wu Y, Liu L, Zhang Y, Wang G, Han D, Ke R, Li S, Feng W, Li M. Activation of AMPK inhibits pulmonary arterial smooth muscle cells proliferation. Exp Lung Res 2015; 40:251-8. [PMID: 24809794 DOI: 10.3109/01902148.2014.913092] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aims of the present study were to examine the effect of AMPK activation on pulmonary arterial smooth muscle cells (PASMCs) proliferation and to address its potential mechanisms. ET-1 dose and time-dependently induced PASMCs proliferation, and this effect was suppressed by a selective AMPK activator metformin. The results of the study further indicated that the proliferation of PASMCs stimulated by ET-1 was associated with the increase of Skp2 and decrease of p27, and metformin reversed ET-1-induced Skp2 elevation and raised p27 protein level. Our study suggests that activation of AMPK suppresses PASMCs proliferation and has potential value in negatively modulating pulmonary vascular remodeling and therefore could prevent or treat the development of pulmonary arterial hypertension (PAH).
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Affiliation(s)
- Yuanyuan Wu
- Department of Respiratory Medicine, Respiratory Diseases Research Center, The Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
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18
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Xiao JW, Zhu XY, Wang QG, Zhang DZ, Cui CS, Zhang P, Chen HY, Meng LL. Acute Effects of Rho-Kinase Inhibitor Fasudil on Pulmonary Arterial Hypertension in Patients With Congenital Heart Defects. Circ J 2015; 79:1342-8. [DOI: 10.1253/circj.cj-14-1015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Jia-wang Xiao
- Department of Congenital Heart Disease, General Hospital of Shenyang Military Area Command
| | - Xian-yang Zhu
- Department of Congenital Heart Disease, General Hospital of Shenyang Military Area Command
| | - Qi-guang Wang
- Department of Congenital Heart Disease, General Hospital of Shenyang Military Area Command
| | - Duan-zhen Zhang
- Department of Congenital Heart Disease, General Hospital of Shenyang Military Area Command
| | - Chun-Sheng Cui
- Department of Congenital Heart Disease, General Hospital of Shenyang Military Area Command
| | - Po Zhang
- Department of Congenital Heart Disease, General Hospital of Shenyang Military Area Command
| | - Huo-yuan Chen
- Department of Congenital Heart Disease, General Hospital of Shenyang Military Area Command
| | - Li-li Meng
- Department of Congenital Heart Disease, General Hospital of Shenyang Military Area Command
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19
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Lee JC, Kim KC, Yang YS, Oh W, Choi SJ, Choe SY, Hong YM. Microarray analysis after umbilical cord blood derived mesenchymal stem cells injection in monocrotaline-induced pulmonary artery hypertension rats. Anat Cell Biol 2014; 47:217-26. [PMID: 25548719 PMCID: PMC4276895 DOI: 10.5115/acb.2014.47.4.217] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 11/27/2014] [Accepted: 12/01/2014] [Indexed: 02/08/2023] Open
Abstract
Pulmonary arterial hypertension (PAH) is associated with structural alterations of lung vasculature. PAH is still a devastating disease needing an aggressive therapeutic approach. Despite the therapeutic potential of human umbilical cord mesenchymal stem cells (MSCs), the molecular parameters to define the stemness remain largely unknown. Using high-density oligonucleotide microarrays, the differential gene expression profiles between a fraction of mononuclear cells of human umbilical cord blood (UCB) and its MSC subpopulation were obtained. Of particular interest was a subset of 46 genes preferentially expressed at 7-fold or higher in the group treated with human UCB-MSCs. This subset contained numerous genes involved in the inflammatory response, immune response, lipid metabolism, cell adhesion, cell migration, cell differentiation, apoptosis, cell growth, transport, cell proliferation, transcription, and signal transduction. Our results provide a foundation for a more reproducible and reliable quality control using genotypic analysis for the definition of human UCB-MSCs. Therefore, our results will provide a basis for studies on molecular mechanisms controlling the core properties of human MSCs.
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Affiliation(s)
- Jae Chul Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea. ; Department of Biology, School of Life Sciences, Chungbuk National University, Cheongju, Korea
| | - Kwan Chang Kim
- Department of Thoracic and Cardiovascular Surgery, Ewha Womans University School of Medicine, Seoul, Korea
| | - Yoon Sun Yang
- Biomedical Research Institute, MEDIPOST, Co., Seoul, Korea
| | - Wonil Oh
- Biomedical Research Institute, MEDIPOST, Co., Seoul, Korea
| | - Soo Jin Choi
- Biomedical Research Institute, MEDIPOST, Co., Seoul, Korea
| | - Soo Young Choe
- Department of Biology, School of Life Sciences, Chungbuk National University, Cheongju, Korea
| | - Young Mi Hong
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
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20
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Huang H, Zarogoulidis P, Lampaki S, Organtzis J, Petridis D, Porpodis K, Papaiwannou A, Karageorgiou V, Pitsiou G, Kioumis I, Hohenforst-Schmidt W, Li Q, Darwiche K, Freitag L, Rapti A, Zarogoulidis K. Experimentation with aerosol bonsetan, pirfenidone, treprostinil and sidenafil. J Thorac Dis 2014; 6:1411-9. [PMID: 25364518 DOI: 10.3978/j.issn.2072-1439.2014.08.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 08/19/2014] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Pulmonary hypertension (PH) has been identified either as a symptom or a primary entity. Several drugs are already on the market and other are being investigated. Idiopathic pulmonary fibrosis (IPF) is also a disease were several drugs are being investigated. MATERIALS AND METHODS Three jet nebulizers and three ultrasound nebulizers were used for our experiments with seven different residual cups and four different loadings. Bonsetan, treprostinil, sidenafil and pirfenidone were modified in order to be produced as aerosol in an effort to identify parameters which influence the droplet size production size. RESULTS The four-way ANOVA on droplet size using the jet nebulizers revealed two statistically significant factors, drug (F=6.326, P=0.0007) and residual cup (F=4.419, P=0.0007), and their interaction term (F=5.829, P<0.0001). Drugs bonsetan and pirfenidone produce equally the lowest mean droplet size (2.63 and 2.80 respectively) as compared to other two drug mean sizes. The ANOVA results, concerning the ultrasound nebulizers, revealed only the nebulizers as producing significant effect on droplet size (F=4.753, P=0.037). DISCUSSION Our study indicates the importance of the initial drug design formulation. Moreover, further investigation of the residual cup design is an additional parameter that can assist in the optimal droplet size production, indifferently of the drug formulation.
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Affiliation(s)
- Haidong Huang
- 1 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece ; 4 Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 II Medical Department, "Coburg" Regional Hospital, Coburg, Germany ; 6 Department of Interventional Pneumology, "Ruhrlandklinik", West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany ; 7 Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Paul Zarogoulidis
- 1 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece ; 4 Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 II Medical Department, "Coburg" Regional Hospital, Coburg, Germany ; 6 Department of Interventional Pneumology, "Ruhrlandklinik", West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany ; 7 Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Sofia Lampaki
- 1 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece ; 4 Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 II Medical Department, "Coburg" Regional Hospital, Coburg, Germany ; 6 Department of Interventional Pneumology, "Ruhrlandklinik", West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany ; 7 Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - John Organtzis
- 1 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece ; 4 Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 II Medical Department, "Coburg" Regional Hospital, Coburg, Germany ; 6 Department of Interventional Pneumology, "Ruhrlandklinik", West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany ; 7 Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Dimitris Petridis
- 1 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece ; 4 Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 II Medical Department, "Coburg" Regional Hospital, Coburg, Germany ; 6 Department of Interventional Pneumology, "Ruhrlandklinik", West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany ; 7 Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Konstantinos Porpodis
- 1 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece ; 4 Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 II Medical Department, "Coburg" Regional Hospital, Coburg, Germany ; 6 Department of Interventional Pneumology, "Ruhrlandklinik", West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany ; 7 Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Antonis Papaiwannou
- 1 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece ; 4 Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 II Medical Department, "Coburg" Regional Hospital, Coburg, Germany ; 6 Department of Interventional Pneumology, "Ruhrlandklinik", West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany ; 7 Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Vasilis Karageorgiou
- 1 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece ; 4 Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 II Medical Department, "Coburg" Regional Hospital, Coburg, Germany ; 6 Department of Interventional Pneumology, "Ruhrlandklinik", West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany ; 7 Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Georgia Pitsiou
- 1 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece ; 4 Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 II Medical Department, "Coburg" Regional Hospital, Coburg, Germany ; 6 Department of Interventional Pneumology, "Ruhrlandklinik", West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany ; 7 Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Ioannis Kioumis
- 1 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece ; 4 Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 II Medical Department, "Coburg" Regional Hospital, Coburg, Germany ; 6 Department of Interventional Pneumology, "Ruhrlandklinik", West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany ; 7 Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Wolfgang Hohenforst-Schmidt
- 1 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece ; 4 Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 II Medical Department, "Coburg" Regional Hospital, Coburg, Germany ; 6 Department of Interventional Pneumology, "Ruhrlandklinik", West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany ; 7 Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Qiang Li
- 1 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece ; 4 Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 II Medical Department, "Coburg" Regional Hospital, Coburg, Germany ; 6 Department of Interventional Pneumology, "Ruhrlandklinik", West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany ; 7 Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Kaid Darwiche
- 1 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece ; 4 Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 II Medical Department, "Coburg" Regional Hospital, Coburg, Germany ; 6 Department of Interventional Pneumology, "Ruhrlandklinik", West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany ; 7 Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Lutz Freitag
- 1 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece ; 4 Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 II Medical Department, "Coburg" Regional Hospital, Coburg, Germany ; 6 Department of Interventional Pneumology, "Ruhrlandklinik", West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany ; 7 Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Aggeliki Rapti
- 1 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece ; 4 Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 II Medical Department, "Coburg" Regional Hospital, Coburg, Germany ; 6 Department of Interventional Pneumology, "Ruhrlandklinik", West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany ; 7 Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Konstantinos Zarogoulidis
- 1 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece ; 4 Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 II Medical Department, "Coburg" Regional Hospital, Coburg, Germany ; 6 Department of Interventional Pneumology, "Ruhrlandklinik", West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany ; 7 Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
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21
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Fukumoto Y. [Role of the Rho-kinase pathway in pulmonary arterial hypertension]. Nihon Yakurigaku Zasshi 2014; 143:178-81. [PMID: 24717605 DOI: 10.1254/fpj.143.178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Seidelmann SB, Lighthouse JK, Greif DM. Development and pathologies of the arterial wall. Cell Mol Life Sci 2014; 71:1977-99. [PMID: 24071897 PMCID: PMC11113178 DOI: 10.1007/s00018-013-1478-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 09/11/2013] [Accepted: 09/12/2013] [Indexed: 01/13/2023]
Abstract
Arteries consist of an inner single layer of endothelial cells surrounded by layers of smooth muscle and an outer adventitia. The majority of vascular developmental studies focus on the construction of endothelial networks through the process of angiogenesis. Although many devastating vascular diseases involve abnormalities in components of the smooth muscle and adventitia (i.e., the vascular wall), the morphogenesis of these layers has received relatively less attention. Here, we briefly review key elements underlying endothelial layer formation and then focus on vascular wall development, specifically on smooth muscle cell origins and differentiation, patterning of the vascular wall, and the role of extracellular matrix and adventitial progenitor cells. Finally, we discuss select human diseases characterized by marked vascular wall abnormalities. We propose that continuing to apply approaches from developmental biology to the study of vascular disease will stimulate important advancements in elucidating disease mechanism and devising novel therapeutic strategies.
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MESH Headings
- Angiogenic Proteins/genetics
- Angiogenic Proteins/metabolism
- Animals
- Arteries/growth & development
- Arteries/metabolism
- Arteries/pathology
- Cardiovascular Diseases/genetics
- Cardiovascular Diseases/metabolism
- Cardiovascular Diseases/pathology
- Cell Differentiation
- Cell Lineage/genetics
- Endothelial Cells/metabolism
- Endothelial Cells/pathology
- Endothelium, Vascular/growth & development
- Endothelium, Vascular/metabolism
- Endothelium, Vascular/pathology
- Gene Expression Regulation, Developmental
- Humans
- Morphogenesis/genetics
- Muscle, Smooth, Vascular/growth & development
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Myocytes, Smooth Muscle/metabolism
- Myocytes, Smooth Muscle/pathology
- Neovascularization, Pathologic
- Neovascularization, Physiologic
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Affiliation(s)
- Sara B. Seidelmann
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale Cardiovascular Research Center, Yale University School of Medicine, 300 George St., Rm 773J, New Haven, CT 06511 USA
| | - Janet K. Lighthouse
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale Cardiovascular Research Center, Yale University School of Medicine, 300 George St., Rm 773J, New Haven, CT 06511 USA
| | - Daniel M. Greif
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale Cardiovascular Research Center, Yale University School of Medicine, 300 George St., Rm 773J, New Haven, CT 06511 USA
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23
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Dai Z, Matsui Y. Pulmonary veno-occlusive disease: an 80-year-old mystery. ACTA ACUST UNITED AC 2014; 88:148-57. [PMID: 24853728 DOI: 10.1159/000359973] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 01/20/2014] [Indexed: 11/19/2022]
Abstract
Pulmonary veno-occlusive disease (PVOD) is a rare form of pulmonary hypertension which occurs in 0.1-0.2 people per million. Its etiology is still poorly understood but is related to several risk factors. The histopathology of PVOD is characterized by intimal fibrosis narrowing or the occlusion of small pulmonary veins or venules. A definitive diagnosis requires a surgical biopsy, which is a risky procedure. Thus, the diagnosis must be based on high clinical suspicion and the results of various diagnostic tests, mainly high-resolution computed tomography, pulmonary function tests, bronchoalveolar lavage, and right heart catheterization. The definitive treatment is limited to lung transplantation. Several pulmonary arterial hypertension-specific agents may cause pulmonary edema in PVOD. However, the cautious use of such medications in selected patients, and surgical or mechanical supports, may successfully bridge patients to transplantation. Given the scant knowledge regarding this entity, future studies with a focus on elucidating the etiology and establishing the optimal treatment are required, as is further development in diagnosis.
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Affiliation(s)
- Zhehao Dai
- Tohoku University School of Medicine, Sendai, Japan
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24
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Murashita T, Okada Y, Kanemitsu H, Fukunaga N, Konishi Y, Nakamura K, Koyama T. The impact of preoperative and postoperative pulmonary hypertension on long-term surgical outcome after mitral valve repair for degenerative mitral regurgitation. Ann Thorac Cardiovasc Surg 2014; 21:53-8. [PMID: 24747547 DOI: 10.5761/atcs.oa.13-00364] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE The aim of this study is to elucidate the impact of preoperative and postoperative pulmonary hypertension (PH) on long-term clinical outcomes after mitral valve repair for degenerative mitral regurgitation. METHODS A total of 654 patients who underwent mitral valve repair for degenerative mitral regurgitation between 1991 and 2010 were retrospectively reviewed. Patients were divided into PH(+) group (137 patients) and PH(-) group (517 patients). Follow-up was complete in 99.0%. The median follow-up duration was 7.5 years. RESULTS Patients in PH(+) group were older, more symptomatic and had higher tricuspid regurgitation grade. Thirty-day mortality was not different between 2 groups (p = 0.975). Long-term survival rate was lower in PH(+) group; 10-year survival rate after the operation was 85.2% ± 4.0% in PH(+) group and 89.7% ± 1.8% in PH(-) group (Log-rank, p = 0.019). The incidence of late cardiac events were not different between groups, however, the recurrence of PH was more frequent in PH(+) group. The recurrence of PH had an adverse impact on survival rate, late cardiac events and symptoms. Univariate analysis showed age and preoperative tricuspid regurgitation grade were the predictors of PH recurrence. CONCLUSION Early surgical indication should be advocated for degenerative mitral regurgitation before the progression of pulmonary hypertension and tricuspid regurgitation.
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Affiliation(s)
- Takashi Murashita
- Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
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25
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Nergui S, Fukumoto Y, Do E Z, Nakajima S, Shimizu T, Ikeda S, Elias-Al-Mamun M, Shimokawa H. Role of endothelial nitric oxide synthase and collagen metabolism in right ventricular remodeling due to pulmonary hypertension. Circ J 2014; 78:1465-74. [PMID: 24705390 DOI: 10.1253/circj.cj-13-1586] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Pulmonary hypertension (PH) causes elevated right ventricular (RV) systolic pressure, RV remodeling and finally RV failure to death. However, the mechanisms of RV remodeling in PH remain to be fully elucidated. METHODS AND RESULTS RV autopsy samples from 6 PH patients with RV failure against 3 age- and sex-matched controls were first examined. Next, RV remodeling in 2 mouse models of chronic hypoxia-induced PH with endothelial nitric oxide synthase-deficient (eNOS(-/-)) and collagenase-resistant knock-in (Col(R/R)) mice were examined. In humans, RV failure was associated with RV hypertrophy, interstitial and perivascular fibrosis, decreased RV capillary density and increased macrophage recruitment. Furthermore, immunostaining showed that perivascular matrix metalloproteinase-2 was increased in PH patients with RV failure. In animals, both hypoxic eNOS(-/-) and Col(R/R) mice developed a greater extent of RV hypertrophy, perivascular remodeling and macrophage infiltration compared with wild-type mice. Capillary rarefaction was developed in hypoxic eNOS(-/-) mice, while Col(R/R) mice were able to increase their capillary density in the RV in response to chronic hypoxia. Both mouse models showed increased autophagy even under normoxic condition. CONCLUSIONS These results indicate that RV remodeling occurs early during PH development through fibrosis, perivascular remodeling, capillary rarefaction and autophagy, in which the eNOS pathway and collagen metabolism might be involved.
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Affiliation(s)
- Suvd Nergui
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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26
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Duluc L, Wojciak-Stothard B. Rho GTPases in the regulation of pulmonary vascular barrier function. Cell Tissue Res 2014; 355:675-85. [PMID: 24599334 DOI: 10.1007/s00441-014-1805-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 01/10/2014] [Indexed: 12/12/2022]
Abstract
Pulmonary endothelial permeability is an important determinant of vascular adaptation to changes in oxygen tension, blood pressure, levels of growth factors or inflammatory cytokines. The Ras homologous (Rho) family of guanosine triphosphate phosphatases (Rho GTPases), key regulators of the actin cytoskeleton, regulate endothelial barrier function in response to a variety of environmental factors and signalling agents via the reorganization of the actin cytoskeleton, changes in receptor trafficking or the phosphorylation of junctional proteins. This review provides a brief summary of recent knowledge on Rho-GTPase-mediated effects on pulmonary endothelial barrier function and focuses in particular on their role in pulmonary vascular disorders, including pulmonary hypertension, chronic obstructive pulmonary disease, acute lung injury and acute respiratory distress syndrome.
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Affiliation(s)
- Lucie Duluc
- Centre for Pharmacology & Therapeutics, Imperial College London, London, UK
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27
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Tatebe S, Fukumoto Y, Oikawa-Wakayama M, Sugimura K, Satoh K, Miura Y, Aoki T, Nochioka K, Miura M, Yamamoto S, Tashiro M, Kagaya Y, Shimokawa H. Enhanced [18F]fluorodeoxyglucose accumulation in the right ventricular free wall predicts long-term prognosis of patients with pulmonary hypertension: a preliminary observational study. Eur Heart J Cardiovasc Imaging 2014; 15:666-72. [DOI: 10.1093/ehjci/jet276] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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28
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Elias-Al-Mamun M, Satoh K, Tanaka SI, Shimizu T, Nergui S, Miyata S, Fukumoto Y, Shimokawa H. Combination Therapy With Fasudil and Sildenafil Ameliorates Monocrotaline-Induced Pulmonary Hypertension and Survival in Rats. Circ J 2014; 78:967-76. [DOI: 10.1253/circj.cj-13-1174] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Md. Elias-Al-Mamun
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Kimio Satoh
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Shin-ichi Tanaka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Toru Shimizu
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Suvd Nergui
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Satoshi Miyata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Yoshihiro Fukumoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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29
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Irisawa H, Takeuchi K, Inui N, Miyakawa S, Morishima Y, Mizushima T, Watanabe H. Incremental Shuttle Walk Test as a Valuable Assessment of Exercise Performance in Patients With Pulmonary Arterial Hypertension. Circ J 2014; 78:215-21. [DOI: 10.1253/circj.cj-13-0238] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Hiroshi Irisawa
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine
| | - Kazuhiko Takeuchi
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine
| | - Naoki Inui
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine
| | - Sachiko Miyakawa
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine
| | - Yutaka Morishima
- Department of Rehabilitation Medicine, Hamamatsu University School of Medicine
| | - Takashi Mizushima
- Department of Rehabilitation Medicine, Hamamatsu University School of Medicine
| | - Hiroshi Watanabe
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine
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30
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Shimizu T, Fukumoto Y, Tanaka SI, Satoh K, Ikeda S, Shimokawa H. Crucial role of ROCK2 in vascular smooth muscle cells for hypoxia-induced pulmonary hypertension in mice. Arterioscler Thromb Vasc Biol 2013; 33:2780-91. [PMID: 24135024 DOI: 10.1161/atvbaha.113.301357] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Rho/Rho-kinase (ROCK) pathway in vascular smooth muscle cells (VSMCs) plays an important role in the pathogenesis of cardiovascular diseases, including pulmonary arterial hypertension (PAH). Rho-kinase has 2 isoforms, ROCK1 and ROCK2, with different functions in different cells; ROCK1 for circulating inflammatory cells and ROCK2 for the vasculature. In the present study, we aimed to examine whether ROCK2 in VSMC is involved in the pathogenesis of PAH. APPROACH AND RESULTS In patients with PAH, the expression of ROCK2 was increased in pulmonary arterial media and primary pulmonary arterial smooth muscle cells when compared with controls. To investigate the role of ROCK2 in VSMC, we generated VSMC-specific heterozygous ROCK2-deficient (ROCK2(+/-)) mice and VSMC-specific ROCK2-overexpressing transgenic (ROCK2-Tg) mice. The extent of hypoxia-induced pulmonary hypertension was reduced in ROCK2(+/-) mice and was enhanced in ROCK2-Tg mice compared with respective littermates. The protein expression of ROCK activity and phosphorylated extracellular signal-regulated kinase and the number of Ki67-positive proliferating cells in the lung were reduced in ROCK2(+/-) mice and were increased in ROCK2-Tg mice compared with respective littermates. In cultured mouse aortic VSMC, migration and proliferation activities were reduced in ROCK2(+/-) mice, and migration activity was increased in ROCK2-Tg mice compared with respective littermates. In addition, in primary pulmonary arterial smooth muscle cells from a patient with PAH, ROCK2 was required for migration and proliferation through ROCK and extracellular signal-regulated kinase activation. CONCLUSIONS ROCK2 in VSMC contributes to the pathogenesis of PAH.
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Affiliation(s)
- Toru Shimizu
- From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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31
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Tang W, Yang J, Zhang F, Guo H, Peng F, Wang X. Activation of extracellular signal-regulated kinase 1/2 and Sp1 may contribute to the expression of tissue inhibitor of metalloproteinases-1 induced by transforming growth factor-β1 in human pulmonary arterial smooth muscle cells. Cytotherapy 2013; 16:225-33. [PMID: 24113427 DOI: 10.1016/j.jcyt.2013.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 07/17/2013] [Accepted: 08/21/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND AIMS Tissue inhibitor of metalloproteinases-1 (TIMP-1) plays an important role in the development of pulmonary arterial hypertension. However, the molecular regulatory mechanisms of TIMP-1 in the pulmonary arteries are not fully understood, especially in human pulmonary arterial smooth muscle cells (HPASMCs). We investigated the signaling pathway involved in the regulation of TIMP-1 in HPASMCs induced by transforming growth factor (TGF)-β1. METHODS Cultured HPASMCs were incubated with different concentrations of TGF-β1 (0-40 ng/mL) for 24 h or with 10 ng/mL TGF-β1 for different times (1-48 h). RESULTS Western blot, real-time polymerase chain reaction and enzyme-linked immunosorbent assay analyses showed that TGF-β1 enhanced the expression and secretion of TIMP-1 in a time-dependent and dose-dependent fashion. TGF-β1 could phosphorylate two of the three mitogen-activated protein kinases-extracellular signal-regulated kinase 1/2 (ERK1/2) and p38, but not c-Jun NH2-terminal kinase. Of these kinases, only the inhibition of ERK1/2 by U0126, which was a specific inhibitor of mitogen-activated protein kinase/ERK1/2, effectively blocked the TGF-β1-induced expression of TIMP-1. Mithramycin, an inhibitor of Sp1 transcription factor, also significantly inhibited the expression of TIMP-1. Additionally, electrophoretic mobility shift assay showed that TGF-β1 could up-regulate the DNA-binding activity of Sp1 and that U0126 and mithramycin could effectively inhibit these events. CONCLUSIONS TGF-β1 could stimulate the expression and secretion of TIMP-1 in HPASMCs in a time-dependent and dose-dependent fashion, and ERK1/2 and Sp1 signaling pathways might be involved in these activities.
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Affiliation(s)
- Weiliang Tang
- Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital of Zhejiang University), Shaoxing City, Zhejiang, PR China; Department of Cardiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, Zhejiang, PR China
| | - Jinxiu Yang
- Department of Cardiology, Zhejiang Traditional Chinese Medical Hospital, Hangzhou City, Zhejiang, PR China
| | - Furong Zhang
- Department of Cardiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, Zhejiang, PR China
| | - Hangyuan Guo
- Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital of Zhejiang University), Shaoxing City, Zhejiang, PR China
| | - Fang Peng
- Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital of Zhejiang University), Shaoxing City, Zhejiang, PR China
| | - Xingxiang Wang
- Department of Cardiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, Zhejiang, PR China.
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32
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Wang Y, Xue XY, Liu YX, Wang KF, Zang XF, Wang J, Wang PL, Zhang J, Pan L, Zhang SY, Wang JX. Pulmonary Arterial Hypertension and MicroRNAs—An Ever-growing Partnership. Arch Med Res 2013; 44:483-7. [DOI: 10.1016/j.arcmed.2013.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 08/14/2013] [Indexed: 01/02/2023]
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33
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Long-term research of stem cells in monocrotaline-induced pulmonary arterial hypertension. Clin Exp Med 2013; 14:439-46. [DOI: 10.1007/s10238-013-0256-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 08/19/2013] [Indexed: 10/26/2022]
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34
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Different sizes of centrilobular ground-glass opacities in chest high-resolution computed tomography of patients with pulmonary veno-occlusive disease and patients with pulmonary capillary hemangiomatosis. Cardiovasc Pathol 2013; 22:287-93. [DOI: 10.1016/j.carpath.2012.12.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 11/07/2012] [Accepted: 12/05/2012] [Indexed: 11/21/2022] Open
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35
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Li G, Liu Y, Zhu Y, Liu A, Xu Y, Li X, Li Z, Su J, Sun L. ACE2 Activation Confers Endothelial Protection and Attenuates Neointimal Lesions in Prevention of Severe Pulmonary Arterial Hypertension in Rats. Lung 2013; 191:327-36. [DOI: 10.1007/s00408-013-9470-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 04/16/2013] [Indexed: 12/13/2022]
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36
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Page A, Ali JM, Maraka J, Mackenzie-Ross R, Jenkins DP. Management of chronic thromboembolic pulmonary hypertension: current status and emerging options. ACTA ACUST UNITED AC 2013. [DOI: 10.2217/cpr.13.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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37
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Platelet-derived growth factor-A and vascular endothelial growth factor-C contribute to the development of pulmonary tumor thrombotic microangiopathy in gastric cancer. Virchows Arch 2013; 462:523-31. [DOI: 10.1007/s00428-013-1403-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Revised: 03/13/2013] [Accepted: 03/15/2013] [Indexed: 11/27/2022]
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38
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Storck EM, Wojciak-Stothard B. Rho GTPases in pulmonary vascular dysfunction. Vascul Pharmacol 2013; 58:202-10. [DOI: 10.1016/j.vph.2012.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 09/05/2012] [Accepted: 09/09/2012] [Indexed: 12/19/2022]
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39
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Novoyatleva T, Schymura Y, Janssen W, Strobl F, Swiercz JM, Patra C, Posern G, Wietelmann A, Zheng TS, Schermuly RT, Engel FB. Deletion of Fn14 receptor protects from right heart fibrosis and dysfunction. Basic Res Cardiol 2013; 108:325. [PMID: 23325387 PMCID: PMC3597271 DOI: 10.1007/s00395-012-0325-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 11/29/2012] [Accepted: 12/17/2012] [Indexed: 12/14/2022]
Abstract
Pulmonary arterial hypertension (PAH) is a fatal disease for which no cure is yet available. The leading cause of death in PAH is right ventricular (RV) failure. Previously, the TNF receptor superfamily member fibroblast growth factor-inducible molecule 14 (Fn14) has been associated with different fibrotic diseases. However, so far there is no study demonstrating a causal role for endogenous Fn14 signaling in RV or LV heart disease. The purpose of this study was to determine whether global ablation of Fn14 prevents RV fibrosis and remodeling improving heart function. Here, we provide evidence for a causative role of Fn14 in pulmonary artery banding (PAB)-induced RV fibrosis and dysfunction in mice. Fn14 expression was increased in the RV after PAB. Mice lacking Fn14 (Fn14−/−) displayed substantially reduced RV fibrosis and dysfunction following PAB compared to wild-type littermates. Cell culture experiments demonstrated that activation of Fn14 induces collagen expression via RhoA-dependent nuclear translocation of myocardin-related transcription factor-A (MRTF-A)/MAL. Furthermore, activation of Fn14 in vitro caused fibroblast proliferation and myofibroblast differentiation, which corresponds to suppression of PAB-induced RV fibrosis in Fn14−/− mice. Moreover, our findings suggest that Fn14 expression is regulated by endothelin-1 (ET-1) in cardiac fibroblasts. We conclude that Fn14 is an endogenous key regulator in cardiac fibrosis and suggest this receptor as potential new target for therapeutic interventions in heart failure.
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Affiliation(s)
- Tatyana Novoyatleva
- Department of Cardiac Development and Remodelling, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
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Qiao LN, Xu HB, Shi K, Zhou TF, Hua YM, Liu HM. Role of notch signal in angiotensin II induced pulmonary vascular remodeling. Transl Pediatr 2013; 2:5-13. [PMID: 26835278 PMCID: PMC4728945 DOI: 10.3978/j.issn.2224-4336.2012.05.03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Notch signal is particularly important to vascular remodeling during the process of embryonic development, vessel repair and tumor growth, but there are few studies about pulmonary vascular remodeling in pulmonary hypertension. This study was to explore the effect of inhibiting Notch signal on pulmonary vascular remodeling induced by angiotensin II. METHODS Vessel strips taken from healthy Wistar rats were cocultured with extrogenous angiotensin II and the potent smooth muscle cell proliferation stimulators for 7 days. Vascular wall thickness, proliferating cell nuclear antigen (PCNA) positive cell rate, and caspase-3 positive cell rate were examined in vessel strips. Some of the vessel strips were cultured with angiotensin II and γ-secretase inhibitor DAPT, a Notch signaling inhibitor, for 7 days. The levels of Notch 1 to 4 receptor and HERP1/2 mRNA were ascertained by FQ-PCR. RESULTS Angiotensin II stimulation in the cultured normal pulmonary arteries resulted in an increase in the vascular medial thickness by nearly 50%, and a significant increase in the PCNA positive cell rate and a decrease in the caspase-3 positive cell rate (P<0.05). DAPT treatment did not alter the levels of Notch 1 to 4 receptor but remarkably decreased HERP1 and HERP2 mRNA expression (P<0.05). DAPT treatment also decreased angiotensin II-induced vascular medial thickness and PCNA positive cell rate, and increased caspase-3 positive cell rate (P<0.05). CONCLUSIONS Inhibition of Notch signal by the γ-secretase inhibitor may suppress pulmonary vascular remodeling induced by angiotensin II, suggesting that the inhibition of Notch signal pathway might be a novel strategy for the treatment of pulmonary hypertension.
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Affiliation(s)
- Li-Na Qiao
- Department of Pediatrics, Second West China Hospital of Sichuan University, Chengdu 610041, China
| | - Hong-Bo Xu
- Department of Pediatrics, Second West China Hospital of Sichuan University, Chengdu 610041, China
| | - Kun Shi
- Department of Pediatrics, Second West China Hospital of Sichuan University, Chengdu 610041, China
| | - Tong-Fu Zhou
- Department of Pediatrics, Second West China Hospital of Sichuan University, Chengdu 610041, China
| | - Yi-Min Hua
- Department of Pediatrics, Second West China Hospital of Sichuan University, Chengdu 610041, China
| | - Han-Min Liu
- Department of Pediatrics, Second West China Hospital of Sichuan University, Chengdu 610041, China
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Resch T, Pircher A, Kähler CM, Pratschke J, Hilbe W. Endothelial progenitor cells: current issues on characterization and challenging clinical applications. Stem Cell Rev Rep 2012; 8:926-39. [PMID: 22095429 DOI: 10.1007/s12015-011-9332-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Since their discovery about a decade ago, endothelial precursor cells (EPC) have been subjected to intensive investigation. The vision to stimulate respectively suppress a key player of vasculogenesis opened a plethora of clinical applications. However, as research opened deeper insights into EPC biology, the enthusiasm of the pioneer era has been damped in favour of a more critical view. Recent research is focused on three major questions: The fact that the number of EPC in peripheral blood is exceedingly low has consistently raised suspicion whether these cells can plausibly have an impact on physiological or pathophysiological processes. Secondly, whereas the key role of EPC in tumourigenesis has been strongly emphasized by various groups in the past, recent publications are challenging this hypothesis. Thirdly, the lack of consensus on EPC-defining markers and standardized protocols for their detection have repeatedly led to difficulties concerning comparability between papers. In this current review, an overview on recent findings on EPC biology is given, their challenging clinical implications are discussed and the perplexity underlying the current controversial debate is illustrated.
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Affiliation(s)
- Thomas Resch
- Center of Operative Medicine, Department of Visceral, Transplant, and Thoracic Surgery, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
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Vera-Lastra O, Porres-Aguilar M. Pulmonary arterial hypertension associated with systemic sclerosis: Current diagnostic approach and therapeutic strategies. World J Rheumatol 2012; 2:12-20. [DOI: 10.5499/wjr.v2.i2.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Pulmonary arterial hypertension (PAH) represents a devastating vascular complication of systemic sclerosis (SSc) and is found in 10%-15% of cases carrying a severe prognosis. PAH has a dramatic impact on the clinical course and overall survival, being the single most common cause of death in patients with this entity. The clinical course and aggressive progression of PAH has led clinicians to perform annual screening for it, since early detection and diagnosis are the cornerstone of a prompt therapeutic intervention. The diagnosis of PAH can be challenging to clinicians, particularly in its early stages, since in the context of SSc, the multiple causes of dyspnea need to be assessed. Doppler echocardiography represents the best initial screening tool, however, right heart catheterization remains the gold standard and definitive diagnostic means. Remarkable advances have been achieved in elucidating the pathogenesis of PAH in the past two decades, leading to the development of disease-specific targeted therapies: prostacyclin analogues, endothelin receptor antagonists and inhibitors of five phosphodiesterase pathways. However, the clinical response to these therapies in SSc-associated PAH has not been as great as the one seen with idiopathic PAH. This review also focuses on the diagnosis and novel therapies that are currently available for PAH, as well as potential future therapeutic developments based on newly acquired knowledge of diverse pathogenic mechanisms.
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Luan Y, Zhang X, Kong F, Cheng GH, Qi TG, Zhang ZH. Mesenchymal stem cell prevention of vascular remodeling in high flow-induced pulmonary hypertension through a paracrine mechanism. Int Immunopharmacol 2012; 14:432-7. [PMID: 22922316 DOI: 10.1016/j.intimp.2012.08.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 08/01/2012] [Accepted: 08/01/2012] [Indexed: 01/31/2023]
Abstract
UNLABELLED Pulmonary arterial hypertension (PAH) is characterized by functional and structural changes in the pulmonary vasculature, and despite the drug treatment that made significant progress, the prognosis of patients with advanced PH remains extremely poor. In the present study, we investigated the early effect of bone marrow mesenchymal stem cells (BMSCs) on experimental high blood flow-induced PAH model rats and discussed the mechanism. BMSCs were isolated, cultured from bone marrow of Sprague-Dawley (SD) rat. The animal model of PAH was created by surgical methods to produce a left-to-right shunt. Following the successful establishment of the PAH model, rats were randomly assigned to three groups (n=20 in each group): sham group (control), PAH group, and BMSC group (received a sublingual vein injection of 1-5 × 10(6) BMSCs). Two weeks after the administration, BMSCs significantly reduced the vascular remodeling, improved the hemodynamic data, and deceased the right ventricle weight ratio to left ventricular plus septal weight (RV/LV+S) (P<0.05). Real-time reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry analysis results indicated that the inflammation factors such as interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) were reduced (P<0.05); the expression of matrix metallo proteinase-9 (MMP-9) was lower (P<0.05); vascular endothelial growth factor (VEGF) was higher in BMSC group than those in PAH group (P<0.05). CONCLUSION Sublingual vein injection of BMSCs for 2 weeks, significantly improved the lung and heart injury caused by left-to-right shunt-induced PAH; decreased pulmonary vascular remodeling and inflammation; and enhanced angiogenesis.
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Affiliation(s)
- Yun Luan
- Central Research Laboratory, The Second Hospital of Shandong University, Jinan, China
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44
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Current World Literature. Curr Opin Cardiol 2012; 27:318-26. [DOI: 10.1097/hco.0b013e328352dfaf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Luan Y, Zhang ZH, Wei DE, Lu Y, Wang YB. Effects of autologous bone marrow mononuclear cells implantation in canine model of pulmonary hypertension. Circ J 2012; 76:977-85. [PMID: 22293449 DOI: 10.1253/circj.cj-11-1175] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND We investigated the safety and feasibility of intratracheal administration of autologous bone marrow-derived mononuclear cells (ABM-MNCs) and observed the effects in a canine model of pulmonary hypertension (PH). METHODS AND RESULTS The PH model was induced by intravenous injection of 3mg/kg dehydromonocrotaline (DMCT) via the right atrium. Two weeks after DMCT administration, the animals received 4 different treatments (n=10 in each group): (I) negative control group; (II): ABM-MNCs group; (III) PH group; (IV) PH+ABM-MNCs group. Six weeks after injection of cells (10⁷), the hemodynamic data were significantly improved in group IV compared with group III (P<0.05). The ratio of right ventricular weight to left ventricular plus septal weight was significantly decreased in group IV compared with group III (P<0.05). The mRNA levels of vascular endothelial growth factor, preproendothelin-1, interleukin-6 and tumor necrosis factor-α were significantly improved in group IV compared with group III (P<0.05). The immunofluorescence result showed that 6 weeks after administration ABM-MNCs could differentiate into pulmonary vascular endothelial cells. CONCLUSIONS Six weeks after intratracheal administration, ABM-MNCs significantly improved the impairment caused by DMCT in a canine model of PH (ie, decreased pulmonary arteriolar narrowing, alveolar septum thickening and right ventricular hypertrophy, enhanced angiogenesis) and this provides a firm foundation for a clinical trial.
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Affiliation(s)
- Yun Luan
- Central Research Laboratory, The Second Hospital of Shandong University, Jinan, China
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Yamada N. Percutaneous transluminal pulmonary angioplasty for distal-type chronic thromboembolic pulmonary hypertension. Circ J 2012; 76:307-8. [PMID: 22240603 DOI: 10.1253/circj.cj-11-1525] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Tatebe S, Fukumoto Y, Sugimura K, Miyamichi-Yamamoto S, Aoki T, Miura Y, Nochioka K, Satoh K, Shimokawa H. Clinical Significance of Reactive Post-Capillary Pulmonary Hypertension in Patients With Left Heart Disease. Circ J 2012; 76:1235-44. [DOI: 10.1253/circj.cj-11-1288] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Shunsuke Tatebe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Yoshihiro Fukumoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | | | - Tatsuo Aoki
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Yutaka Miura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Kotaro Nochioka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Kimio Satoh
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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Yanagisawa R, Kataoka M, Taguchi H, Kawakami T, Tamura Y, Fukuda K, Yoshino H, Satoh T. Impact of First-Line Sildenafil Monotreatment for Pulmonary Arterial Hypertension. Circ J 2012; 76:1245-52. [DOI: 10.1253/circj.cj-11-1192] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Ryoji Yanagisawa
- Second Department of Internal Medicine, Kyorin University School of Medicine
| | - Masaharu Kataoka
- Second Department of Internal Medicine, Kyorin University School of Medicine
- Department of Cardiology, Keio University School of Medicine
| | - Hiroki Taguchi
- Second Department of Internal Medicine, Kyorin University School of Medicine
| | | | - Yuichi Tamura
- Department of Cardiology, Keio University School of Medicine
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine
| | - Hideaki Yoshino
- Second Department of Internal Medicine, Kyorin University School of Medicine
| | - Toru Satoh
- Second Department of Internal Medicine, Kyorin University School of Medicine
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Sugimura K, Fukumoto Y, Satoh K, Nochioka K, Miura Y, Aoki T, Tatebe S, Miyamichi-Yamamoto S, Shimokawa H. Percutaneous transluminal pulmonary angioplasty markedly improves pulmonary hemodynamics and long-term prognosis in patients with chronic thromboembolic pulmonary hypertension. Circ J 2011; 76:485-8. [PMID: 22185711 DOI: 10.1253/circj.cj-11-1217] [Citation(s) in RCA: 231] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Distal-type chronic thromboembolic pulmonary hypertension (CTEPH) is a fatal disease for which a new therapeutic strategy needs to be developed. We examined the effects of percutaneous transluminal pulmonary angioplasty (PTPA). METHODS AND RESULTS We prospectively enrolled 12 patients with distal-type CTEPH. After stabilizing their condition with pulmonary vasodilators, we then performed PTPA, which markedly improved pulmonary hemodynamics and pulmonary artery structure, as confirmed by angiography and optical coherence tomography, and also significantly improved their long-term prognosis compared with 39 historical controls. CONCLUSIONS PTPA is a promising therapeutic option for distal-type CTEPH.
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Affiliation(s)
- Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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