1
|
Hu Y, Wang Y, Wang S, Cui X, Feng Y, Li Z, Ji K, Wang J, Sun C, Tang Y, Li Y. Efficacy and Safety of Suxiao Jiuxin Pills in the Treatment of Chronic Coronary Syndrome with Intolerance to Adverse Effects of Long-acting Nitrates: A Multicenter, Randomized, Double-blind, Placebo-controlled Study. BMC Complement Med Ther 2024; 24:356. [PMID: 39367481 PMCID: PMC11451125 DOI: 10.1186/s12906-024-04661-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 09/23/2024] [Indexed: 10/06/2024] Open
Abstract
BACKGROUND This study aims to investigate the short-term effects and safety of adjunct Suxiao Jiuxin Pills (SJPs) on conventional therapy in chronic coronary syndrome (CCS) patients who are intolerant to the adverse effects of long-acting nitrates. METHODS This was a multicenter, randomized, double-blind, placebo-controlled trial. A total of 174 CCS participants from eight clinical study centers in China were included in the modified intention-to-treat analyses. Participants with CCS and intolerance to the adverse effects of long-acting nitrates were recruited and randomized to either the SJPs or the placebo group for a duration of 4 weeks. RESULTS Compared to the placebo group, the SJPs group showed a significant improvement in the efficacy rate after 4 weeks (OR = 2.43, 95% CI = 1.32 to 4.47, P = 0.004). Besides, individuals without a history of alcohol consumption showed a greater improvement in the SAQ summary score compared to those with a history of alcohol consumption. CONCLUSION Adjunctive SJPs enhance the effectiveness of short-term conventional anti-angina treatment for patients with CCS who experience intolerance to long-acting nitrates, without significant adverse effects during application. TRIAL REGISTRATION Chinese Clinical Trials Registry Platform, ChiCTR2100050066. Registered 16 August 2021, https://www.chictr.org.cn/showproj.html?proj=131470 .
Collapse
Grants
- National Administration of Traditional Chinese Medicine, Teaching and Education Letter 2023 No. 85 Key Discipline Construction Project of Traditional Chinese Medicine Cardiology in the State Administration of Traditional Chinese Medicine
- National Administration of Traditional Chinese Medicine, Teaching and Education Letter 2023 No. 85 Key Discipline Construction Project of Traditional Chinese Medicine Cardiology in the State Administration of Traditional Chinese Medicine
- National Administration of Traditional Chinese Medicine, Teaching and Education Letter 2023 No. 85 Key Discipline Construction Project of Traditional Chinese Medicine Cardiology in the State Administration of Traditional Chinese Medicine
- National Administration of Traditional Chinese Medicine, Teaching and Education Letter 2023 No. 85 Key Discipline Construction Project of Traditional Chinese Medicine Cardiology in the State Administration of Traditional Chinese Medicine
- National Administration of Traditional Chinese Medicine, Teaching and Education Letter 2023 No. 85 Key Discipline Construction Project of Traditional Chinese Medicine Cardiology in the State Administration of Traditional Chinese Medicine
- National Administration of Traditional Chinese Medicine, Teaching and Education Letter 2023 No. 85 Key Discipline Construction Project of Traditional Chinese Medicine Cardiology in the State Administration of Traditional Chinese Medicine
- National Administration of Traditional Chinese Medicine, Teaching and Education Letter 2023 No. 85 Key Discipline Construction Project of Traditional Chinese Medicine Cardiology in the State Administration of Traditional Chinese Medicine
- National Administration of Traditional Chinese Medicine, Teaching and Education Letter 2023 No. 85 Key Discipline Construction Project of Traditional Chinese Medicine Cardiology in the State Administration of Traditional Chinese Medicine
- National Administration of Traditional Chinese Medicine, Teaching and Education Letter 2023 No. 85 Key Discipline Construction Project of Traditional Chinese Medicine Cardiology in the State Administration of Traditional Chinese Medicine
- National Administration of Traditional Chinese Medicine, Teaching and Education Letter 2023 No. 85 Key Discipline Construction Project of Traditional Chinese Medicine Cardiology in the State Administration of Traditional Chinese Medicine
- National Administration of Traditional Chinese Medicine, Teaching and Education Letter 2023 No. 85 Key Discipline Construction Project of Traditional Chinese Medicine Cardiology in the State Administration of Traditional Chinese Medicine
- 82274471 National Natural Science Foundation of China
Collapse
Affiliation(s)
- Yuanlong Hu
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Yifei Wang
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Shiqin Wang
- Zibo City Traditional Chinese Medicine Hospital, Zibo, Shandong, China
| | - Xirong Cui
- Yantai Penglai Traditional Chinese Medicine Hospital, Yantai, Shandong, China
| | - Yong Feng
- Qufu Hospital of Traditional Chinese Medicine, Qufu, Shandong, China
| | - Zhengguang Li
- Qingdao Hospital of Traditional Chinese Medicine (Qingdao Hiser hospital), Qingdao, Shandong, China
| | - Kegang Ji
- Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong, China
| | - Jianming Wang
- Xiyuan Hospital Jining Hospital, Jining, Shandong, China
| | - Chenghua Sun
- Linqu Hospital of Traditional Chinese Medicine, Weifang, Shandong, China
| | - Yan Tang
- Rongcheng Hospital of Chinese Medicine, Weihai, Shandong, China
| | - Yunlun Li
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
| |
Collapse
|
2
|
Li H, Liu J, Liang Q, Yu Y, Sun G. Effect of Vascular Senescence on the Efficacy and Safety of Warfarin: Insights from Rat Models and a Prospective Cohort Study. J Pharmacol Exp Ther 2024; 391:39-50. [PMID: 39095206 DOI: 10.1124/jpet.124.002265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 07/03/2024] [Accepted: 07/12/2024] [Indexed: 08/04/2024] Open
Abstract
Warfarin, with its narrow therapeutic range, requires the understanding of various influencing factors for personalized medication. Vascular senescence, marked by vascular stiffening and endothelial dysfunction, has an unclear effect on the efficacy and safety of warfarin. Based on previous studies, we hypothesized that vascular senescence increases the risk of bleeding during warfarin therapy. This study aimed to explore these effects using animal models and clinical cohorts. We established rat models of vascular senescence and calcification using d-galactose, vitamin D, and nicotine. After validating the models, we examined changes in the international normalized ratio (INR) at fixed warfarin doses (0.20 and 0.35 mg/kg). We found that vascular senescence caused significantly elevated INR values and increased bleeding risk. In the prospective clinical cohort study (NCT06428110), hospitalized warfarin patients with standard dose adjustments were divided into vascular senescence and control groups based on ultrasound and computed tomography diagnosis. Using propensity score matching to exclude the influence of confounding factors, we found that the vascular senescence group had lower steady-state warfarin doses and larger dose adjustments, with a higher probability of INR exceeding the therapeutic range. The vascular senescence group tended to experience more bleeding or thromboembolic/ischemic events during 1 year of follow-up, while there was no statistical difference. In conclusion, vascular senescence leads to unstable INR values and increases higher bleeding risk during warfarin therapy, highlighting the importance of considering vascular senescence in future precision warfarin therapies. SIGNIFICANCE STATEMENT: Many factors influence warfarin efficacy; however, the effect of vascular senescence remains unclear. This study aimed to investigate the effects of vascular senescence on the efficacy and safety of warfarin. Through both rat models and clinical cohort studies, our findings indicated that vascular senescence may compromise the stability of warfarin, presenting challenges in maintaining its efficacy and safety.
Collapse
Affiliation(s)
- Haobin Li
- Department of Pharmacy, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Jing Liu
- Department of Pharmacy, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Qing Liang
- Department of Pharmacy, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Yan Yu
- Department of Pharmacy, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Guangchun Sun
- Department of Pharmacy, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| |
Collapse
|
3
|
Verlinden SF. The genetic advantage of healthy centenarians: unraveling the central role of NLRP3 in exceptional healthspan. FRONTIERS IN AGING 2024; 5:1452453. [PMID: 39301197 PMCID: PMC11410711 DOI: 10.3389/fragi.2024.1452453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 08/19/2024] [Indexed: 09/22/2024]
Abstract
Despite extensive research into extending human healthspan (HS) and compressing morbidity, the mechanisms underlying aging remain elusive. However, a better understanding of the genetic advantages responsible for the exceptional HS of healthy centenarians (HC), who live in good physical and mental health for one hundred or more years, could lead to innovative health-extending strategies. This review explores the role of NLRP3, a critical component of innate immunity that significantly impacts aging. It is activated by pathogen-associated signals and self-derived signals that increase with age, leading to low-grade inflammation implicated in age-related diseases. Furthermore, NLRP3 functions upstream in several molecular aging pathways, regulates cellular senescence, and may underlie the robust health observed in HC. By targeting NLRP3, mice exhibit a phenotype akin to that of HC, the HS of monkeys is extended, and aging symptoms are reversed in humans. Thus, targeting NLRP3 could offer a promising approach to extend HS. Additionally, a paradigm shift is proposed. Given that the HS of the broader population is 30 years shorter than that of HC, it is postulated that they suffer from a form of accelerated aging. The term 'auto-aging' is suggested to describe accelerated aging driven by NLRP3.
Collapse
|
4
|
Khan D, Zhou H, You J, Kaiser VA, Khajuria RK, Muhammad S. Tobacco smoke condensate-induced senescence in endothelial cells was ameliorated by colchicine treatment via suppression of NF-κB and MAPKs P38 and ERK pathways activation. Cell Commun Signal 2024; 22:214. [PMID: 38570838 PMCID: PMC10988825 DOI: 10.1186/s12964-024-01594-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/24/2024] [Indexed: 04/05/2024] Open
Abstract
Smoking is the major cause of cardiovascular diseases and cancer. It induces oxidative stress, leading to DNA damage and cellular senescence. Senescent cells increase the expression and release of pro-inflammatory molecules and matrix metalloproteinase, which are known to play a vital role in the initiation and progression of cardiovascular diseases and metastasis in cancer. The current study investigated the smoking induced cellular senescence and employed colchicine that blocked senescence in endothelial cells exposed to tobacco smoke condensate. Colchicine prevented oxidative stress and DNA damage in tobacco smoke-condensate-treated endothelial cells. Colchicin reduced β-gal activity, improved Lamin B1, and attenuated cell growth arrest markers P21 and P53. Colchicine also ameliorated the expression of SASP factors and inhibited the activation of NF-kB and MAPKs P38 and ERK. In summary, colchicine inhibited tobacco smoke condensate-induced senescence in endothelial cells by blocking the activation of NF-kB and MAPKs P38 and ERK.
Collapse
Affiliation(s)
- Dilaware Khan
- Department of Neurosurgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine- Universität Düsseldorf, Moorenstr.5, Düsseldorf, 40225, Germany
| | - Huakang Zhou
- Department of Neurosurgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine- Universität Düsseldorf, Moorenstr.5, Düsseldorf, 40225, Germany
| | - Jinliang You
- Department of Neurosurgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine- Universität Düsseldorf, Moorenstr.5, Düsseldorf, 40225, Germany
| | - Vera Annika Kaiser
- Department of Neurosurgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine- Universität Düsseldorf, Moorenstr.5, Düsseldorf, 40225, Germany
| | - Rajiv K Khajuria
- Department of Neurosurgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine- Universität Düsseldorf, Moorenstr.5, Düsseldorf, 40225, Germany
| | - Sajjad Muhammad
- Department of Neurosurgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine- Universität Düsseldorf, Moorenstr.5, Düsseldorf, 40225, Germany.
- Department of Neurosurgery, University Hospital Helsinki, Topeliuksenkatu 5, Helsinki, 00260, Finland.
| |
Collapse
|
5
|
Khan D, Li X, Hashimoto T, Tanikawa R, Niemela M, Lawton M, Muhammad S. Current Mouse Models of Intracranial Aneurysms: Analysis of Pharmacological Agents Used to Induce Aneurysms and Their Impact on Translational Research. J Am Heart Assoc 2024; 13:e031811. [PMID: 38258667 PMCID: PMC11056163 DOI: 10.1161/jaha.123.031811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/06/2023] [Indexed: 01/24/2024]
Abstract
Intracranial aneurysms (IAs) are rare vascular lesions that are more frequently found in women. The pathophysiology behind the formation and growth of IAs is complex. Hence, to date, no single pharmacological option exists to treat them. Animal models, especially mouse models, represent a valuable tool to explore such complex scientific questions. Genetic modification in a mouse model of IAs, including deletion or overexpression of a particular gene, provides an excellent means for examining basic mechanisms behind disease pathophysiology and developing novel pharmacological approaches. All existing animal models need some pharmacological treatments, surgical interventions, or both to develop IAs, which is different from the spontaneous and natural development of aneurysms under the influence of the classical risk factors. The benefit of such animal models is the development of IAs in a limited time. However, clinical translation of the results is often challenging because of the artificial course of IA development and growth. Here, we summarize the continuous improvement in mouse models of IAs. Moreover, we discuss the pros and cons of existing mouse models of IAs and highlight the main translational roadblocks and how to improve them to increase the success of translational IA research.
Collapse
Affiliation(s)
- Dilaware Khan
- Department of NeurosurgeryMedical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐Universität DüsseldorfDüsseldorfGermany
| | - Xuanchen Li
- Department of NeurosurgeryMedical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐Universität DüsseldorfDüsseldorfGermany
| | - Tomoki Hashimoto
- Department of Neurosurgery and NeurobiologyBarrow Neurological InstitutePhoenixAZUSA
| | - Rokuya Tanikawa
- Department of Neurosurgery, Stroke CenterSapporo Teishinkai HospitalSapporoHokkaidoJapan
| | - Mika Niemela
- Department of NeurosurgeryUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Michael Lawton
- Department of Neurological SurgeryBarrow Neurological Institute, St. Joseph’s Hospital and Medical CenterPhoenixAZUSA
| | - Sajjad Muhammad
- Department of NeurosurgeryMedical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐Universität DüsseldorfDüsseldorfGermany
- Department of NeurosurgeryUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| |
Collapse
|
6
|
Zhou H, Khan D, Hussain SM, Gerdes N, Hagenbeck C, Rana M, Cornelius JF, Muhammad S. Colchicine prevents oxidative stress-induced endothelial cell senescence via blocking NF-κB and MAPKs: implications in vascular diseases. J Inflamm (Lond) 2023; 20:41. [PMID: 38001470 PMCID: PMC10675905 DOI: 10.1186/s12950-023-00366-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Smoking, alcohol abuse, and hypertension are - among others, potential risk factors for cardiovascular diseases. These risk factors generate oxidative stress and cause oxidative stress-induced DNA damage, resulting in cellular senescence and senescence-associated secretory phenotype (SASP). The SASP factors in feed-forward response exacerbate inflammation and cause tissue remodeling, resulting in atherosclerotic plaque formation and rupture. RESULTS Colchicine inhibited ROS generation and mitigated oxidative stress-induced DNA damage. It dampened oxidative stress-induced endothelial cell senescence and improved the expression of DNA repair protein KU80 and aging marker Lamin B1. The drug attenuated the expression of senescence marker P21 at mRNA and protein levels. The pathway analysis showed that colchicine inhibited NF-κB and MAPKs pathways and subdued mTOR activation. Colchicine also attenuated mRNA expression of interleukin (IL)-1β, IL-6, IL-8, MCP-1, ICAM-1, and E-selectin. Furthermore, colchicine reduced the mRNA and protein expression of matrix metalloproteinase (MMP-2). CONCLUSION In summary, colchicine blocked oxidative stress-induced senescence and SASP by inhibiting the activation of NF-κB and MAPKs pathways.
Collapse
Affiliation(s)
- Huakang Zhou
- Department of Neurosurgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine- Universität Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Dilaware Khan
- Department of Neurosurgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine- Universität Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
| | - Sajid Muhammad Hussain
- Cologne Center for Genomics (CCG), University of Cologne, Weyertal 115b, 50931, Cologne, Germany
| | - Norbert Gerdes
- Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty and University Hospital, Heinrich-Heine-University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
- Cardiovascular Reasearch Institute Düsseldorf (CARID), Medical Faculty, Heinrich-Heine- University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Carsten Hagenbeck
- Clinic for Gynecology and Obstetrics, Medical Faculty, Heinrich-Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Majeed Rana
- Department of Oral-, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Jan Frederick Cornelius
- Department of Neurosurgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine- Universität Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Sajjad Muhammad
- Department of Neurosurgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine- Universität Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
- Department of Neurosurgery, University Hospital Helsinki, Topeliuksenkatu 5, Helsinki, 00260, Finland
- Department of Neurosurgery, King Edward Medical University, Lahore, Pakistan
| |
Collapse
|
7
|
Zhou H, Li X, Rana M, Cornelius JF, Khan D, Muhammad S. mTOR Inhibitor Rapalink-1 Prevents Ethanol-Induced Senescence in Endothelial Cells. Cells 2023; 12:2609. [PMID: 37998344 PMCID: PMC10670449 DOI: 10.3390/cells12222609] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023] Open
Abstract
The cardiovascular risk factors, including smoking, ethanol, and oxidative stress, can induce cellular senescence. The senescent cells increase the expression and release of pro-inflammatory molecules and matrix metalloproteinase (MMPs). These pro-inflammatory molecules and MMPs promote the infiltration and accumulation of inflammatory cells in the vascular tissue, exacerbating vascular tissue inflammation. MMPs damage vascular tissue by degenerating the extracellular matrix. Consequently, these cellular and molecular events promote the initiation and progression of cardiovascular diseases. We used Rapalink-1, an mTOR inhibitor, to block ethanol-induced senescence. Rapalink-1 inhibited oxidative-stress-induced DNA damage and senescence in endothelial cells exposed to ethanol. It attenuated the relative protein expression of senescence marker P21 and improved the relative protein expression of DNA repair protein KU70 and aging marker Lamin B1. It inhibited the activation of NF-κB, MAPKs (P38 and ERK), and mTOR pathway proteins (mTOR, 4EBP-1, and S6). Moreover, Rapalink-1 suppressed ethanol-induced mRNA expression of ICAM-1, E-selectin, MCP-1, IL-8, MMP-2, and TIMP-2. Rapalink-1 also reduced the relative protein expression of MMP-2. In summary, Rapalink-1 prevented senescence, inhibited pro-inflammatory pathway activation, and ameliorated pro-inflammatory molecule expression and MMP-2.
Collapse
Affiliation(s)
- Huakang Zhou
- Department of Neurosurgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Moorenstrasse 5, 40225 Düsseldorf, Germany (S.M.)
| | - Xuanchen Li
- Department of Neurosurgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Moorenstrasse 5, 40225 Düsseldorf, Germany (S.M.)
| | - Majeed Rana
- Department of Oral and Maxillofacial Surgery, Medical Faculty, Heinrich-Heine-University, Moorenstrasse 5, 40225 Düsseldorf, Germany
| | - Jan Frederick Cornelius
- Department of Neurosurgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Moorenstrasse 5, 40225 Düsseldorf, Germany (S.M.)
| | - Dilaware Khan
- Department of Neurosurgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Moorenstrasse 5, 40225 Düsseldorf, Germany (S.M.)
| | - Sajjad Muhammad
- Department of Neurosurgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Moorenstrasse 5, 40225 Düsseldorf, Germany (S.M.)
- Department of Neurosurgery, University Hospital Helsinki, Topeliuksenkatu 5, 00260 Helsinki, Finland
- Department of Neurosurgery, King Edward Medical University, Lahore 54000, Pakistan
| |
Collapse
|
8
|
Khan D, Cornelius JF, Muhammad S. The Role of NF-κB in Intracranial Aneurysm Pathogenesis: A Systematic Review. Int J Mol Sci 2023; 24:14218. [PMID: 37762520 PMCID: PMC10531594 DOI: 10.3390/ijms241814218] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Intracranial aneurysms (IAs) are abnormal dilations of the cerebral vessels, which pose a persistent threat of cerebral hemorrhage. Inflammation is known to contribute to IA development. The nuclear factor "kappa-light-chain-enhancer" of activated B-cells (NF-κB) is the major driver of inflammation. It increases the expression of inflammatory markers and matrix metalloproteinases (MMPs), which contribute heavily to the pathogenesis of IAs. NF-κB activation has been linked to IA rupture and resulting subarachnoid hemorrhage. Moreover, NF-κB activation can result in endothelial dysfunction, smooth muscle cell phenotypic switching, and infiltration of inflammatory cells in the arterial wall, which subsequently leads to the initiation and progression of IAs and consequently results in rupture. After a systematic search, abstract screening, and full-text screening, 30 research articles were included in the review. In this systematic review, we summarized the scientific literature reporting findings on NF-κB's role in the pathogenesis of IAs. In conclusion, the activation of the NF-κB pathway was associated with IA formation, progression, and rupture.
Collapse
Affiliation(s)
- Dilaware Khan
- Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-Universität Düsseldorf, 40225 Düsseldorf, Germany; (D.K.)
| | - Jan Frederick Cornelius
- Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-Universität Düsseldorf, 40225 Düsseldorf, Germany; (D.K.)
| | - Sajjad Muhammad
- Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-Universität Düsseldorf, 40225 Düsseldorf, Germany; (D.K.)
- Department of Neurosurgery, University Hospital Helsinki, Topeliuksenkatu 5, 00260 Helsinki, Finland
- Department of Neurosurgery, King Edward Medical University, Lahore 54000, Pakistan
| |
Collapse
|