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Potoka KP, Wood KC, Baust JJ, Bueno M, Hahn SA, Vanderpool RR, Bachman T, Mallampalli GM, Osei-Hwedieh DO, Schrott V, Sun B, Bullock GC, Becker-Pelster EM, Wittwer M, Stampfuss J, Mathar I, Stasch JP, Truebel H, Sandner P, Mora AL, Straub AC, Gladwin MT. Nitric Oxide-Independent Soluble Guanylate Cyclase Activation Improves Vascular Function and Cardiac Remodeling in Sickle Cell Disease. Am J Respir Cell Mol Biol 2019; 58:636-647. [PMID: 29268036 DOI: 10.1165/rcmb.2017-0292oc] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Sickle cell disease (SCD) is associated with intravascular hemolysis and oxidative inhibition of nitric oxide (NO) signaling. BAY 54-6544 is a small-molecule activator of oxidized soluble guanylate cyclase (sGC), which, unlike endogenous NO and the sGC stimulator, BAY 41-8543, preferentially binds and activates heme-free, NO-insensitive sGC to restore enzymatic cGMP production. We tested orally delivered sGC activator, BAY 54-6544 (17 mg/kg/d), sGC stimulator, BAY 41-8543, sildenafil, and placebo for 4-12 weeks in the Berkeley transgenic mouse model of SCD (BERK-SCD) and their hemizygous (Hemi) littermate controls (BERK-Hemi). Right ventricular (RV) maximum systolic pressure (RVmaxSP) was measured using micro right-heart catheterization. RV hypertrophy (RVH) was determined using Fulton's index and RV corrected weight (ratio of RV to tibia). Pulmonary artery vasoreactivity was tested for endothelium-dependent and -independent vessel relaxation. Right-heart catheterization revealed higher RVmaxSP and RVH in BERK-SCD versus BERK-Hemi, which worsened with age. Treatment with the sGC activator more effectively lowered RVmaxSP and RVH, with 90-day treatment delivering superior results, when compared with other treatments and placebo groups. In myography experiments, acetylcholine-induced (endothelium-dependent) and sodium-nitroprusside-induced (endothelium-independent NO donor) relaxation of the pulmonary artery harvested from placebo-treated BERK-SCD was impaired relative to BERK-Hemi but improved after therapy with sGC activator. By contrast, no significant effect for sGC stimulator or sildenafil was observed in BERK-SCD. These findings suggest that sGC is oxidized in the pulmonary arteries of transgenic SCD mice, leading to blunted responses to NO, and that the sGC activator, BAY 54-6544, may represent a novel therapy for SCD-associated pulmonary arterial hypertension and cardiac remodeling.
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Affiliation(s)
- Karin P Potoka
- 1 Division of Newborn Medicine, Department of Pediatrics.,2 Heart, Lung, Blood, and Vascular Medicine Institute, Department of Medicine
| | - Katherine C Wood
- 2 Heart, Lung, Blood, and Vascular Medicine Institute, Department of Medicine.,3 University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jeffrey J Baust
- 2 Heart, Lung, Blood, and Vascular Medicine Institute, Department of Medicine
| | - Marta Bueno
- 2 Heart, Lung, Blood, and Vascular Medicine Institute, Department of Medicine.,4 Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Scott A Hahn
- 2 Heart, Lung, Blood, and Vascular Medicine Institute, Department of Medicine
| | | | - Tim Bachman
- 2 Heart, Lung, Blood, and Vascular Medicine Institute, Department of Medicine
| | - Grace M Mallampalli
- 2 Heart, Lung, Blood, and Vascular Medicine Institute, Department of Medicine.,3 University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Valerie Schrott
- 2 Heart, Lung, Blood, and Vascular Medicine Institute, Department of Medicine
| | - Bin Sun
- 2 Heart, Lung, Blood, and Vascular Medicine Institute, Department of Medicine
| | - Grant C Bullock
- 2 Heart, Lung, Blood, and Vascular Medicine Institute, Department of Medicine
| | | | | | | | | | | | - Hubert Truebel
- 5 Bayer AG, Wuppertal, Germany.,6 University of Witten/Herdecke, Witten, Germany
| | - Peter Sandner
- 5 Bayer AG, Wuppertal, Germany.,8 Hannover Medical School, Hannover, Germany; and
| | - Ana L Mora
- 2 Heart, Lung, Blood, and Vascular Medicine Institute, Department of Medicine.,4 Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Adam C Straub
- 2 Heart, Lung, Blood, and Vascular Medicine Institute, Department of Medicine.,9 Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mark T Gladwin
- 2 Heart, Lung, Blood, and Vascular Medicine Institute, Department of Medicine.,4 Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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