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Örnek E, Alkan M, Erel S, Yığman Z, Dursun AD, Dağlı A, Sarıkaya B, Kip G, Polat Y, Arslan M. Effects of Sevoflurane and Fullerenol C60 on the Heart and Lung in Lower-Extremity Ischemia-Reperfusion Injury in Streptozotocin-Induced Diabetes Mice. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1232. [PMID: 39202513 PMCID: PMC11356023 DOI: 10.3390/medicina60081232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 07/21/2024] [Accepted: 07/25/2024] [Indexed: 09/03/2024]
Abstract
Background and Objectives: Lower-extremity ischemia-reperfusion injury can induce distant organ ischemia, and patients with diabetes are particularly susceptible to ischemia-reperfusion injury. Sevoflurane, a widely used halogenated inhalation anesthetic, and fullerenol C60, a potent antioxidant, were investigated for their effects on heart and lung tissues in lower-extremity ischemia-reperfusion injury in streptozotocin (STZ)-induced diabetic mice. Materials and Methods: A total of 41 mice were divided into six groups: control (n = 6), diabetes-control (n = 7), diabetes-ischemia (n = 7), diabetes-ischemia-fullerenol C60 (n = 7), diabetes-ischemia-sevoflurane (n = 7), and diabetes-ischemia-fullerenol C60-sevoflurane (n = 7). Diabetes was induced in mice using a single intraperitoneal dose of 55 mg/kg STZ in all groups except for the control group. Mice in the control and diabetes-control groups underwent midline laparotomy and were sacrificed after 120 min. The DIR group underwent 120 min of lower-extremity ischemia followed by 120 min of reperfusion. In the DIR-F group, mice received 100 μg/kg fullerenol C60 intraperitoneally 30 min before IR. In the DIR-S group, sevoflurane and oxygen were administered during the IR procedure. In the DIR-FS group, fullerenol C60 and sevoflurane were administered. Biochemical and histological evaluations were performed on collected heart and lung tissues. Results: Histological examination of heart tissues showed significantly higher necrosis, polymorphonuclear leukocyte infiltration, edema, and total damage scores in the DIR group compared to controls. These effects were attenuated in fullerenol-treated groups. Lung tissue examination revealed more alveolar wall edema, hemorrhage, vascular congestion, polymorphonuclear leukocyte infiltration, and higher total damage scores in the DIR group compared to controls, with reduced injury parameters in the fullerenol-treated groups. Biochemical analyses indicated significantly higher total oxidative stress, oxidative stress index, and paraoxonase-1 levels in the DIR group compared to the control and diabetic groups. These levels were lower in the fullerenol-treated groups. Conclusions: Distant organ damage in the lung and heart tissues due to lower-extremity ischemia-reperfusion injury can be significantly reduced by fullerenol C60.
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Affiliation(s)
- Ender Örnek
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Gazi University, Ankara 06560, Turkey; (E.Ö.); (M.A.); (S.E.); (G.K.)
| | - Metin Alkan
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Gazi University, Ankara 06560, Turkey; (E.Ö.); (M.A.); (S.E.); (G.K.)
| | - Selin Erel
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Gazi University, Ankara 06560, Turkey; (E.Ö.); (M.A.); (S.E.); (G.K.)
| | - Zeynep Yığman
- Department of Histology and Embryology, Faculty of Medicine, Gazi University, Ankara 06560, Turkey; (Z.Y.); (A.D.)
- Neuroscience and Neurotechnology Center of Excellence (NOROM), Gazi University, Ankara 06560, Turkey
| | - Ali Doğan Dursun
- Department of Physiology, Faculty of Medicine, Atılım University, Ankara 06830, Turkey; (A.D.D.); (B.S.)
| | - Aslı Dağlı
- Department of Histology and Embryology, Faculty of Medicine, Gazi University, Ankara 06560, Turkey; (Z.Y.); (A.D.)
- Medical Laboratory Techniques Program, Department of Medical Services and Techniques, Vocational School of Health Services, Atılım University, Ankara 06830, Turkey
| | - Badegül Sarıkaya
- Department of Physiology, Faculty of Medicine, Atılım University, Ankara 06830, Turkey; (A.D.D.); (B.S.)
| | - Gülay Kip
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Gazi University, Ankara 06560, Turkey; (E.Ö.); (M.A.); (S.E.); (G.K.)
| | - Yücel Polat
- Tekirdağ Dr İsmail Fehmi Cumalıoğlu City Hospital, Department of Cardiovascular Surgery, Tekirdağ 59030, Turkey;
| | - Mustafa Arslan
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Gazi University, Ankara 06560, Turkey; (E.Ö.); (M.A.); (S.E.); (G.K.)
- Life Sciences Application and Research Center, Gazi University, Ankara 06560, Turkey
- Laboratory Animal Breeding and Experimental Research Center (GUDAM), Gazi University, Ankara 06560, Turkey
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Zhou M, Wang K, Jin Y, Liu J, Wang Y, Xue Y, Liu H, Chen Q, Cao Z, Jia X, Rui Y. Explore novel molecular mechanisms of FNDC5 in ischemia-reperfusion (I/R) injury by analyzing transcriptome changes in mouse model of skeletal muscle I/R injury with FNDC5 knockout. Cell Signal 2024; 113:110959. [PMID: 37918465 DOI: 10.1016/j.cellsig.2023.110959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/18/2023] [Accepted: 10/30/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Irisin, a myokine derived from proteolytic cleavage of the fibronectin type III domain-containing protein 5 (FNDC5) protein, is crucial in protecting tissues and organs from ischemia-reperfusion (I/R) injury. However, the underlying mechanism of its action remains elusive. In this study, we investigated the expression patterns of genes associated with FNDC5 knockout to gain insights into its molecular functions. METHODS We employed a mouse model of skeletal muscle I/R injury with FNDC5 knockout to examine the transcriptional profiles using RNA sequencing. Differentially expressed genes (DEGs) were identified and subjected to further analyses, including gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment, protein-protein interaction (PPI) network analysis, and miRNA-transcription factor network analysis. The bioinformatics findings were validated using qRT-PCR and Western blotting. RESULTS Comparative analysis of skeletal muscle transcriptomes between wild-type (WT; C57BL/6), WT-I/R, FNDC5 knockout (KO), and KO-I/R mice highlighted the significance of FNDC5 in both physiological conditions and I/R injury. Through PPI network analysis, we identified seven key genes (Col6a2, Acta2, Col4a5, Fap, Enpep, Mmp11, and Fosl1), which facilitated the construction of a TF-hub genes-miRNA regulatory network. Additionally, our results suggested that the PI3K-Akt pathway is predominantly involved in FNDC5 deletion-mediated I/R injury in skeletal muscle. Animal studies revealed reduced FNDC5 expression in skeletal muscle following I/R injury, and the gastrocnemius muscle with FNDC5 knockout exhibited larger infarct size and more severe tissue damage after I/R. Moreover, Western blot analysis confirmed the upregulation of Col6a2, Enpep, and Mmp11 protein levels following I/R, particularly in the KO-I/R group. Furthermore, FNDC5 deletion inhibited the PI3K-Akt signaling pathway. CONCLUSION This study demonstrates that FNDC5 deletion exacerbates skeletal muscle I/R injury, potentially involving the upregulation of Col6a2, Enpep, and Mmp11. Additionally, the findings suggest the involvement of the PI3K-Akt pathway in FNDC5 deletion-mediated skeletal muscle I/R injury, providing novel insights into the molecular mechanisms underlying FNDC5's role in this pathological process.
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Affiliation(s)
- Ming Zhou
- Suzhou Medical College of Soochow University, Suzhou, China; Department of Orthopaedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi 214000, China.
| | - Kai Wang
- Suzhou Medical College of Soochow University, Suzhou, China; Department of Orthopaedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi 214000, China
| | - Yesheng Jin
- Suzhou Medical College of Soochow University, Suzhou, China; Department of Orthopaedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi 214000, China
| | - Jinquan Liu
- Suzhou Medical College of Soochow University, Suzhou, China; Department of Orthopaedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi 214000, China
| | - Yapeng Wang
- Department of Orthopaedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi 214000, China
| | - Yuan Xue
- Department of Orthopaedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi 214000, China
| | - Hao Liu
- Suzhou Medical College of Soochow University, Suzhou, China; Department of Orthopaedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi 214000, China
| | - Qun Chen
- Suzhou Medical College of Soochow University, Suzhou, China
| | - Zhihai Cao
- Suzhou Medical College of Soochow University, Suzhou, China; Department of Emergency, The Third Affiliated Hospital of Soochow University, Changzhou 213000, China
| | - Xueyuan Jia
- Department of Orthopaedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi 214000, China
| | - Yongjun Rui
- Suzhou Medical College of Soochow University, Suzhou, China; Department of Orthopaedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi 214000, China.
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Candesartan protects against unilateral peripheral limb ischemia in type-2 diabetic rats: Possible contribution of PI3K-Akt-eNOS-VEGF angiogenic signaling pathway. Int Immunopharmacol 2023; 116:109817. [PMID: 36773570 DOI: 10.1016/j.intimp.2023.109817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/27/2023] [Accepted: 01/28/2023] [Indexed: 02/11/2023]
Abstract
Type-2 diabetes (T2DM) is known to be highly associated with increased risk for vascular complications including peripheral arterial diseases (PAD). Critical limb ischemia (CLI) is the most advanced stage of PAD. Current therapeutic options for diabetic patients experiencing vascular complications are limited to surgical revascularization with no effective pharmacotherapy available for clinical settings. This study is dedicated to evaluate the angiogenic potential of candesartan an angiotensin-II receptor blocker in an experimental model of vascular complications associating T2DM. T2DM was induced in rats through feeding with high fat diet for 6 weeks, followed by injection with streptozotocin (STZ, 30 mg/kg; i.p). After establishment of T2DM, unilateral CLI was induced through the ligation and excision of superficial femoral artery. Candesartan treatment (10 or 30 mg/kg; orally) was initiated one day post CLI and thereafter once daily for up to 14 days. T2DM rats that underwent CLI demonstrated impaired angiogenic signaling, increased inflammation and apoptosis in gastrocnemius muscle (GC). Candesartan reversed ischemic insult in T2DM rats subjected to unilateral CLI and induced reparative angiogenesis that was evident by increase in p-PI3K/PI3K, p-Akt/Akt, p-eNOS/eNOS, p-VEGFR2/VEGFR2 ratios, and VEGF levels. Candesartan treatment also increased levels of HO-1; while decreased caspase-3 apoptotic marker and levels of inflammatory markers; NF-κB and TNF-α, all of which were accompanied by preserved histological manifestations of GC muscles. Candesartan was able to combat limb ischemia under diabetic conditions which could pave the way for its therapeutic utility for diabetic patients experiencing vascular complications in clinical setting.
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Vanhorebeek I, Gunst J, Casaer MP, Derese I, Derde S, Pauwels L, Segers J, Hermans G, Gosselink R, Van den Berghe G. Skeletal Muscle Myokine Expression in Critical Illness, Association With Outcome and Impact of Therapeutic Interventions. J Endocr Soc 2023; 7:bvad001. [PMID: 36726836 PMCID: PMC9879715 DOI: 10.1210/jendso/bvad001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Indexed: 01/09/2023] Open
Abstract
Context Muscle expresses and secretes several myokines that bring about benefits in distant organs. Objective We investigated the impact of critical illness on muscular expression of irisin, kynurenine aminotransferases, and amylase; association with clinical outcome; and impact of interventions that attenuate muscle wasting/weakness. Methods We studied critically ill patients who participated in 2 randomized controlled trials (EPaNIC/NESCI) and documented time profiles in critically ill mice. Included in the study were 174 intensive care unit (ICU) patients (day 8 ± 1) vs 19 matched controls, and 60 mice subjected to surgery/sepsis vs 60 pair-fed healthy mice. Interventions studied included 7-day neuromuscular electrical stimulation (NMES), and withholding parenteral nutrition (PN) in the first ICU week (late PN) vs early PN. The main outcome measures were FNDC5 (irisin- precursor), KYAT1, KYAT3, and amylase mRNA expression in skeletal muscle. Results Critically ill patients showed 34% to 80% lower mRNA expression of FNDC5, KYAT1, and amylases than controls (P < .0001). Critically ill mice showed time-dependent reductions in all mRNAs compared with healthy mice (P ≤ .04). The lower FNDC5 expression in patients was independently associated with a higher ICU mortality (P = .015) and ICU-acquired weakness (P = .012), whereas the lower amylase expression in ICU survivors was independently associated with a longer ICU stay (P = .0060). Lower amylase expression was independently associated with a lower risk of death (P = .048), and lower KYAT1 expression with a lower risk of weakness (P = .022). NMES increased FNDC5 expression compared with unstimulated muscle (P = .016), and late PN patients had a higher KYAT1 expression than early PN patients (P = .022). Conclusion Expression of the studied myokines was affected by critical illness and associated with clinical outcomes, with limited effects of interventions that attenuate muscle wasting or weakness.
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Affiliation(s)
- Ilse Vanhorebeek
- Correspondence: Prof. Ilse Vanhorebeek, MEng, PhD, Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000 Leuven, Belgium;. ; or Prof. Greet Van den Berghe, MD, PhD, Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000 Leuven, Belgium.
| | - Jan Gunst
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium,Clinical Division of Intensive Care Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Michaël P Casaer
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium,Clinical Division of Intensive Care Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Inge Derese
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Sarah Derde
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Lies Pauwels
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Johan Segers
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Greet Hermans
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium,Medical Intensive Care Unit, Department of General Internal Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Rik Gosselink
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Greet Van den Berghe
- Correspondence: Prof. Ilse Vanhorebeek, MEng, PhD, Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000 Leuven, Belgium;. ; or Prof. Greet Van den Berghe, MD, PhD, Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000 Leuven, Belgium.
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ŞAHİN U, DURSUN AD. Oxidative stress indicators during the course of acute graft versus host disease. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1172571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Aim: This prospective study aimed to observe the changes in oxidative stress indicators, including total anti-oxidant status (TAS), total oxidant status (TOS), paraoxanase-1 (PON1), total thiol (TT), native thiol (NT), disulphide (DS) and nitric oxide (NO) levels from sequential blood samples obtained during a de-novo episode of acute graft versus host disease (aGvHD) and evaluate their association with disease severity and the risk of steroid resistant disease.
Material and Method: Sequential patients who underwent an allogeneic stem cell transplantation (ASCT) in our unit and subsequently developed a de-novo episode of aGvHD between January 2022 and May 2022 were included in case they gave informed consent. All patients were started high dose (2 mg/kg/day) methylprednisolone as institutional standard first-line treatment of aGvHD as soon as the clinical diagnosis is evident. All episodes were confirmed simultaneously with gastrointestinal (GI) endoscopy and/or skin biopsies. TAS, TOS, PON1, TT, NT, DS and NO were studied from blood samples collected on days 0, +3 and +7 of steroid treatment. Demographic characteristics, diagnoses, donor type, GvHD prophylaxis, stage and grade of aGvHD, performance status (PS), the presence of cytomegalovirus (CMV) reactivation and response to steroid therapy were also noted.
Results: A total of 15 cases was included. The median age was 49 (23-77). Males constituted 60.0% (n=9). The most frequent diagnosis and donor type were acute leukemia (53.3%, n=8) and matched related donor (46.7%, n=7), respectively. High grade aGvHD with Glucksberg grading and International Bone Marrow Transplant Registry severity index (IBMTR-SI) included 53,3% (n=8) and 86.7% (n=10) of cases, respectively. Non-responders (20.0%, n=3) significantly had advanced stage GI involvement, higher grade of aGvHD with Glucksberg grading and IBMTR-SI, and lower PS (p=0.005, p=0.04, p=0.006, and p=0.02, respectively). The changes in TAS, TOS, PON1, TT, NT, DS and NO levels on days 0, +3 and +7 of steroid treatment were not significant. Median PON1 levels on days 0, +3 and +7 of steroid treatment were significantly lower among non-responders (p
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Dursun AD, Saricam E, Sariyildiz GT, Iscanli MD, Cantekin ÖF. The Evaluation of Oxidative Stress in the Young Adults with COVID-19 mRNA Vaccines Induced Acute Pericarditis- Myopericarditis. Int J Gen Med 2022; 15:161-167. [PMID: 35023954 PMCID: PMC8747758 DOI: 10.2147/ijgm.s347977] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/22/2021] [Indexed: 12/12/2022] Open
Abstract
Background During COVID-19 pandemic, several vaccines have been developed such as mRNA vaccines. However, acute pericarditis and myocarditis/myopericarditis cases have been described after mRNA vaccination. The mechanism for the development of cardiac involvement is unknown. Potential mechanism for oxidative stress associated with vaccine-induced heart involvement is unidentified. This study aimed to examine the role of oxidative stress and the heart involvement in young adults vaccinated with COVID-19 mRNA vaccines. Methods In this cross-sectional study, a total of 23 participants were included and 10 of these participants were asymptomatic patients (control group). Comparison of the cardiac involvement and control group was made by using troponin I, C-reactive protein (hsCRP), D-dimer levels, and oxidative stress tests including nitric oxide, and imaging techniques (ECG, echocardiography, cardiovascular magnetic resonance). Results The median age of acute pericarditis group (10 patients) was 22 years (Q1-Q3: 18.5–31), and the mean age was 24.4±7.5 years. The median age of myopericarditis group (3 patients) was 22 years (Q1–Q3 18.0–25.0), and the mean age was 21.6 ±3.5 years. All the myopericarditis cases were male. The patients with myopericarditis had higher troponin I level, hsCRP, and D-dimer levels (troponin I level; 1600.00 ng/mL; D-dimer; 1.20 μg/mL, hsCRP; 3.0 mg/L, respectively; p < 0.05). Serum nitric oxide levels and OSI (total oxidant status, H2O2/total antioxidant status) were lower in myopericarditis group than the control and acute pericarditis group (p < 0.05). This shows inflammatory and procoagulant state. Conclusion Vaccine-induced myopericarditis cases are associated with oxidative stress test abnormality (abnormal NO, OSI levels). However, there is no relationship between NO levels and other oxidative stress tests difference in vaccine-induced acute pericarditis. It is thought that vaccine-induced pericarditis and myopericarditis could have different pathogenesis. This could make it necessary to reassess the second dose of vaccination for vaccine-induced cardiac involvement cases.
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Affiliation(s)
- Ali Dogan Dursun
- Department of Physiology, Atılım University School of Medicine, Ankara, Turkey.,Check-Up Center, Home Care Services, Medicana International Ankara Hospital, Ankara, Turkey
| | - Ersin Saricam
- Department of Cardiology, Medicana International Ankara Hospital, Ankara, Turkey.,Department of Cardiology, Atılım University School of Medicine, Ankara, Turkey
| | - Gulcin Turkmen Sariyildiz
- Department of General Surgery, Medicana International Ankara Hospital, Ankara, Turkey.,Operating Room Services, Vocational School of Health Services, Atılım University, Ankara, Turkey
| | - Murat Doğan Iscanli
- Department of Emergency Medicine, Medicana International Ankara Hospital, Ankara, Turkey.,Department of Emergency Medicine, Atılım University School of Medicine, Ankara, Turkey
| | - Ömer Faruk Cantekin
- Faculty of Health Sciences, Department of Social Work, Gazi University, Ankara, Turkey
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Irisin: A Promising Target for Ischemia-Reperfusion Injury Therapy. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:5391706. [PMID: 34745418 PMCID: PMC8570861 DOI: 10.1155/2021/5391706] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/08/2021] [Accepted: 10/18/2021] [Indexed: 12/01/2022]
Abstract
Ischemia-reperfusion injury (IRI) is defined as the total combined damage that occurs during a period of ischemia and following the recovery of blood flow. Oxidative stress, mitochondrial dysfunction, and an inflammatory response are factors contributing to IRI-related damage that can each result in cell death. Irisin is a polypeptide that is proteolytically cleaved from the extracellular domain of fibronectin type III domain-containing protein 5 (FNDC5). Irisin acts as a myokine that potentially mediates beneficial effects of exercise by reducing oxidative stress, improving mitochondrial fitness, and suppressing inflammation. The existing literature also suggests a possible link between irisin and IRI, involving mechanisms similar to those associated with exercise. This article will review the pathogenesis of IRI and the potential benefits and current limitations of irisin as a therapeutic strategy for IRI, while highlighting the mechanistic correlations between irisin and IRI.
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Sarıçam E, Dursun AD, Türkmen Sarıyıldız G, Can N, Bozkurt E, Gönüllü U, Basay N, Türkmen M, Denli A, Ünlü M. Laboratory and Imaging Evaluation of Cardiac Involvement in Patients with Post-Acute COVID-19. Int J Gen Med 2021; 14:4977-4985. [PMID: 34511982 PMCID: PMC8412825 DOI: 10.2147/ijgm.s321156] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/02/2021] [Indexed: 12/21/2022] Open
Abstract
Background In the post-acute COVID-19 syndrome, many patients suffer from palpitations, effort-associated fatigue, and even sudden death. The mechanism of heart involvement in this syndrome is uncertain. The main purpose of the study was to identify possible cardiac involvement causes in patients with post-acute COVID-19 by using biomarkers such as NT-proBNP and nitric oxide (NO) and cardiac imaging modalities. Methods In this cross-sectional study, a total of 105 participants were included according to the existence of symptoms, and 40 of these participants were asymptomatic patients. The ages of the participants ranged from 20 to 50 years. All patients were healthy before COVID-19. The symptoms were defined as palpitations and/or fatigue association with exercise in post-acute COVID-19 term. The comparison of the two groups was made by using biochemical parameters (NT-proBNP, Troponin I, NO) and imaging techniques (echocardiography, cardiovascular magnetic resonance (CMR) and cardiac positron emission tomography (PET)). Results The symptomatic patients had higher NT-proBNP levels compared with asymptomatic patients (132.30±35.15; 76.86±16.79, respectively; p < 0.001). Interestingly, the symptomatic patients had lower NO levels than asymptomatic patients (9.20±3.08; 16.15±6.02, respectively; p < 0.001). Echocardiography and CMR were normal. However, we found regional increased 18F-FDG uptake on cardiac PET to be compatible with myocardial fatigue. Conclusion We found elevated NT-proNBP levels, low serum NO levels, and increased 18F-FDG uptake on cardiac PET in post-acute COVID syndrome. Cardiac PET could replace or be added to CMR for detecting subtle subacute/chronic myocarditis. The follow-up of patients with post-acute COVID-19 could target the possibility of risk of heart failure.
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Affiliation(s)
- Ersin Sarıçam
- Department of Cardiology, Medicana International Ankara Hospital, Ankara, Turkey.,Department of Cardiology, Atılım University Medical School, Ankara, Turkey
| | - Ali Doğan Dursun
- Department of Physiology, Atılım University Medical School, Ankara, Turkey.,Check-up Center, Home Care Services, Medicana International Ankara Hospital, Ankara, Turkey
| | - Gülçin Türkmen Sarıyıldız
- Department of General Surgery, Medicana International Ankara Hospital, Ankara, Turkey.,Operating Room Services, Vocational School of Health Services, Atılım University, Ankara, Turkey
| | - Nalan Can
- Department of Nuclear Medicine, Medicana International Ankara Hospital, Ankara, Turkey
| | - Engin Bozkurt
- Department of Cardiology, Medicana International Ankara Hospital, Ankara, Turkey
| | - Uğur Gönüllü
- Department of Pulmonary Medicine, Atılım University Medical School, Ankara, Turkey
| | - Nihal Basay
- Department of Pulmonary Medicine, Medicana International Ankara Hospital, Ankara, Turkey
| | - Meral Türkmen
- Department of Internal Medicine, Medicana International Ankara Hospital, Ankara, Turkey
| | - Abdülaziz Denli
- Department of Physical Medicine and Rehabilitation, Medicana International Ankara Hospital, Ankara, Turkey
| | - Mustafa Ünlü
- Department of Nuclear Medicine, Gazi University Medical School, Ankara, Turkey
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