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Narkar VA. Exercise and Ischemia-Activated Pathways in Limb Muscle Angiogenesis and Vascular Regeneration. Methodist Debakey Cardiovasc J 2023; 19:58-68. [PMID: 38028974 PMCID: PMC10655757 DOI: 10.14797/mdcvj.1304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Exercise has a profound effect on cardiovascular disease, particularly through vascular remodeling and regeneration. Peripheral artery disease (PAD) is one such cardiovascular condition that benefits from regular exercise or rehabilitative physical therapy in terms of slowing the progression of disease and delaying amputations. Various rodent pre-clinical studies using models of PAD and exercise have shed light on molecular pathways of vascular regeneration. Here, I review key exercise-activated signaling pathways (nuclear receptors, kinases, and hypoxia inducible factors) in the skeletal muscle that drive paracrine regenerative angiogenesis. The rationale for highlighting the skeletal muscle is that it is the largest organ recruited during exercise. During exercise, skeletal muscle releases several myokines, including angiogenic factors and cytokines that drive tissue vascular regeneration via activation of endothelial cells, as well as by recruiting immune and endothelial progenitor cells. Some of these core exercise-activated pathways can be extrapolated to vascular regeneration in other organs. I also highlight future areas of exercise research (including metabolomics, single cell transcriptomics, and extracellular vesicle biology) to advance our understanding of how exercise induces vascular regeneration at the molecular level, and propose the idea of "exercise-mimicking" therapeutics for vascular recovery.
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Affiliation(s)
- Vihang A. Narkar
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School, UTHealth, Houston, Texas, US
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He Y, Li W, Liu Z, Zhang J, Guan M. Clinical and genetic analysis of essential hypertension with CYB gene m.15024G>A mutation. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:510-517. [PMID: 37643984 PMCID: PMC10507372 DOI: 10.3724/zdxbyxb-2023-0283] [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: 06/19/2023] [Accepted: 07/20/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVES To explore the role of mitochondrial CYB 15024G>A mutation in the development of essential hypertension. METHODS Mitochondrial genome sequences of hypertensive patients were obtained from previous studies. Clinical and genetic data of a hypertensive patient with mitochondrial CYB 15024G>A mutation and its pedigree were analyzed. Lymphocytes derived from patient and family members were transformed into immortalized lymphoblastoid cell lines, and the levels of adenosine triphosphate (ATP), mitochondrial membrane potential and intracellular reactive oxygen species (ROS) were detected. RESULTS The penetrance of this essential hypertension family was 42.9%, and the age of onset was 46-68 years old. Mitochondrial genome sequencing results showed that all maternal members carried a highly conserved mitochondrial CYB 15024G>A mutation. This mutation could affect the free energy of mitochondrial CYB for secondary and tertiary structure and protein folding, thereby changing its structural stability and the structure of the electron transfer function area around the mutation site. Compared with the control, the cell line carrying the mitochondrial CYB 15024G>A mutation showed significantly decreased levels of mitochondrial CYB, ATP and mitochondrial membrane potential, and increased levels of ROS (P<0.01). CONCLUSIONS Mitochondrial CYB 15024G>A mutation may affect the structure of respiratory chain subunits and mitochondrial function, leading to cell dysfunction, which suggests that the mutation may play a synergistic role in essential hypertension.
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Affiliation(s)
- Yunfan He
- School of Laboratory Medicine and Life Sciences, Attardi Institute of Mitochondrial Biomedicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.
| | - Wenxu Li
- School of Laboratory Medicine and Life Sciences, Attardi Institute of Mitochondrial Biomedicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
| | - Zhen Liu
- School of Laboratory Medicine and Life Sciences, Attardi Institute of Mitochondrial Biomedicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
| | - Juanjuan Zhang
- School of Laboratory Medicine and Life Sciences, Attardi Institute of Mitochondrial Biomedicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
- Eye Hospital, Wenzhou Medical University, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou 325027, China
| | - Minxin Guan
- School of Laboratory Medicine and Life Sciences, Attardi Institute of Mitochondrial Biomedicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.
- Institute of Genetics, Zhejiang University, Zhejiang Provincial Key Lab of Genetic and Developmental Disorders, Hangzhou 310058, China.
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Frese JP, Schawe L, Carstens J, Milbergs K, Speichinger F, Gratl A, Greiner A, Raude B. A Modified Run-Off Resistance Score from Cross-Sectional Imaging Discriminates Chronic Critical Limb Ischemia from Intermittent Claudication in Peripheral Arterial Disease. Diagnostics (Basel) 2022; 12:diagnostics12123155. [PMID: 36553161 PMCID: PMC9777427 DOI: 10.3390/diagnostics12123155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/03/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022] Open
Abstract
Atherosclerotic peripheral arterial disease (PAD) leads to intermittent claudication (IC) and may progress into chronic limb-threatening ischemia (CLTI). Scoring systems to determine the atherosclerotic burden of a diseased extremity have been developed. This study aimed to evaluate a modification of the run-off resistance (mROR) score for its usability in cross-sectional imaging. The mROR was determined from preoperative imaging of patients undergoing revascularization for PAD. A total of 20 patients with IC and 20 patients with CLTI were consecutively included. A subgroup analysis for diabetic patients was conducted. The mROR was evaluated for its correlation with disease severity and clinical covariates. Patients with CLTI were older; cardiovascular risk factors, diabetes, and ASA 4 were more frequent. The mROR scores were higher in CLTI than in IC. In diabetic patients, no difference was detected between CLTI and IC. In CLTI, non-diabetic patients had a higher mROR. The mROR score is positively correlated with the severity of PAD and can discriminate CLTI from IC. In diabetic patients with CLTI, the mROR is lower than in non-diabetic patients. The mROR score can be determined from cross-sectional imaging angiographies. It may be useful for clinicians helping with vascular case planning, as well as for scientific purposes.
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Affiliation(s)
- Jan Paul Frese
- Department of Vascular Surgery, Charité–Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Larissa Schawe
- Department of Vascular Surgery, Charité–Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Jan Carstens
- Department of Vascular Surgery, Charité–Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Karlis Milbergs
- Department of Vascular Surgery, Charité–Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Fiona Speichinger
- Department of Vascular Surgery, Charité–Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Alexandra Gratl
- Department of Vascular Surgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Andreas Greiner
- Department of Vascular Surgery, Charité–Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Ben Raude
- Department of Vascular Surgery, Charité–Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany
- Correspondence: ; Tel.: +49-30-450-522-725
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Wang J, Tang Y, Liu Y, Cai W, Xu J. Correlations between circulating methylmalonic acid levels and all-cause and cause-specific mortality among patients with diabetes. Front Nutr 2022; 9:974938. [DOI: 10.3389/fnut.2022.974938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/11/2022] [Indexed: 11/30/2022] Open
Abstract
AimsEvidence regarding serum methylmalonic acid (MMA) levels and mortality in individuals with diabetes is limited. This study aimed to evaluate the correlation between MMA and all-cause and cause-specific deaths in patients with diabetes.Materials and methodsThis is a population-based cohort study based on data from both the National Health and Nutrition Examination Survey (NHANES) and National Death Index from 1999 to 2014. We assessed the association of serum MMA concentrations with mortality using Cox proportional hazard models after adjusting for lifestyle, demographic factors, and comorbidities.ResultsAmong the 3,097 participants, 843 mortalities occurred during a median follow-up of 4.42 years. There were 242 deaths due to cardiovascular disease (CVD) and 131 cancer-associated deaths. After multivariate adjustment, elevated serum MMA levels were markedly correlated with a high risk of all-cause, CVD-, and cancer-related deaths. Each one-unit increase in the natural log-transformed MMA level correlated with increased risk of all-cause mortality (2.652 times), CVD mortality risk (3.153 times), and cancer-related mortality risk (4.514). Hazard ratios (95% confidence intervals [CIs]) after comparing participants with MMA < 120 and ≥250 nmol/L were 2.177 (1.421–3.336) for all-cause mortality, 3.560 (1.809–7.004) for CVD mortality, and 4.244 (1.537–11.721) for cancer mortality.ConclusionHigher serum MMA levels were significantly associated with higher all-cause, CVD, and cancer mortality. These findings suggest that maintaining lower MMA status may lower mortality risk in individuals with diabetes.
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Anderson EM, Kim K, Fazzone BJ, Harland KC, Hu Q, Salyers Z, Palzkill VR, Cort TA, Kunz EM, Martin AJ, Neal D, O’Malley KA, Berceli SA, Ryan TE, Scali ST. Influences of renal insufficiency and ischemia on mitochondrial bioenergetics and limb dysfunction in a novel murine iliac arteriovenous fistula model. JVS Vasc Sci 2022; 3:345-362. [PMID: 36439698 PMCID: PMC9692039 DOI: 10.1016/j.jvssci.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 10/06/2022] [Indexed: 11/05/2022] Open
Abstract
Objective Hand disability after hemodialysis access surgery has been common yet has remained poorly understood. Arteriovenous fistula (AVF) hemodynamic perturbations have not reliably correlated with the observed measures of hand function. Chronic kidney disease (CKD) is known to precipitate myopathy; however, the interactive influences of renal insufficiency and ischemia on limb outcomes have remained unknown. We hypothesized that CKD would contribute to access-related hand dysfunction via altered mitochondrial bioenergetics. Using a novel murine AVF model, we sought to characterize the skeletal muscle outcomes in mice with and without renal insufficiency. Methods Male, 8-week-old C57BL/6J mice were fed either an adenine-supplemented diet to induce renal insufficiency (CKD) or a casein-based control chow (CON). After 2 weeks of dietary intervention, the mice were randomly assigned to undergo iliac AVF surgery (n = 12/group) or a sham operation (n = 5/group). Measurements of aortoiliac hemodynamics, hindlimb perfusion, and hindlimb motor function were collected for 2 weeks. The mice were sacrificed on postoperative day 14 to assess skeletal muscle histopathologic features and mitochondrial function. To assess the late outcome trends, 20 additional mice had undergone CKD induction and sham (n = 5) or AVF (n = 15) surgery and followed up for 6 weeks postoperatively before sacrifice. Results The adenine-fed mice had had a significantly reduced glomerular filtration rate and elevated blood urea nitrogen, confirming the presence of CKD. The sham mice had a 100% survival rate and AVF cohorts an 82.1% survival rate with an 84.4% AVF patency rate. The aorta and inferior vena cava velocity measurements and the vessel diameter had increased after AVF creation (P < .0001 vs sham). The AVF groups had had a 78.4% deficit in paw perfusion compared with the contralateral limb after surgery (P < .0001 vs sham). Mitochondrial function was influenced by the presence of CKD. The respiratory capacity of the CKD-sham mice (8443 ± 1509 pmol/s/mg at maximal energy demand) was impaired compared with that of the CON-sham mice (12,870 ± 1203 pmol/s/mg; P = .0001). However, this difference was muted after AVF creation (CKD-AVF, 4478 ± 3685 pmol/s/mg; CON-AVF, 5407 ± 3582 pmol/s/mg; P = .198). The AVF cohorts had had impairments in grip strength (vs sham; P < .0001) and gait (vs sham; P = .012). However, the presence of CKD did not significantly alter the measurements of gross muscle function. The paw perfusion deficits had persisted 6 weeks postoperatively for the AVF mice (P < .0001 vs sham); however, the myopathy had resolved (grip strength, P = .092 vs sham; mitochondrial respiration, P = .108 vs sham). Conclusions CKD and AVF-induced distal limb ischemia both impaired skeletal muscle mitochondrial function. Renal insufficiency was associated with a baseline myopathy that was exacerbated by the acute ischemic injury resulting from AVF creation. However, ischemia was the primary driver of the observed phenotype of gross motor impairment. This model reliably reproduced the local and systemic influences that contribute to access-related hand dysfunction and provides a platform for further mechanistic and therapeutic investigation.
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Affiliation(s)
- Erik M. Anderson
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL
- Malcolm Randall Veterans Affairs Medical Center, Gainesville, FL
| | - Kyoungrae Kim
- Department of Applied Physiology and Kinesiology, Center for Exercise Science, University of Florida, Gainesville, FL
| | - Brian J. Fazzone
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL
- Malcolm Randall Veterans Affairs Medical Center, Gainesville, FL
| | - Kenneth C. Harland
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL
- Malcolm Randall Veterans Affairs Medical Center, Gainesville, FL
| | - Qiongyao Hu
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL
- Malcolm Randall Veterans Affairs Medical Center, Gainesville, FL
| | - Zach Salyers
- Department of Applied Physiology and Kinesiology, Center for Exercise Science, University of Florida, Gainesville, FL
| | - Victoria R. Palzkill
- Department of Applied Physiology and Kinesiology, Center for Exercise Science, University of Florida, Gainesville, FL
| | - Tomas A. Cort
- Department of Applied Physiology and Kinesiology, Center for Exercise Science, University of Florida, Gainesville, FL
| | - Eric M. Kunz
- Department of Applied Physiology and Kinesiology, Center for Exercise Science, University of Florida, Gainesville, FL
| | - Andrew J. Martin
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL
- Malcolm Randall Veterans Affairs Medical Center, Gainesville, FL
| | - Dan Neal
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL
| | - Kerri A. O’Malley
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL
- Malcolm Randall Veterans Affairs Medical Center, Gainesville, FL
| | - Scott A. Berceli
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL
- Malcolm Randall Veterans Affairs Medical Center, Gainesville, FL
| | - Terence E. Ryan
- Department of Applied Physiology and Kinesiology, Center for Exercise Science, University of Florida, Gainesville, FL
| | - Salvatore T. Scali
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL
- Malcolm Randall Veterans Affairs Medical Center, Gainesville, FL
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Gratl A, Lobenwein D, Gummerer M, Wipper S. Die Etablierung eines neuen Forschungskonzepts an einem universitären Standort. GEFÄSSCHIRURGIE 2022; 27:239-245. [PMID: 35702688 PMCID: PMC9185131 DOI: 10.1007/s00772-022-00900-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 11/30/2022]
Abstract
Neben der klinischen Tätigkeit haben an einem universitären Standort Forschung und Lehre einen großen Stellenwert. Durch die Etablierung eines neuen Forschungslabors an der Universitätsklinik für Gefäßchirurgie der Medizinischen Universität Innsbruck wurden die infrastrukturellen Voraussetzungen zur Gestaltung eines neuen Forschungsschwerpunkts geschaffen. Die Kooperation mit nationalen und internationalen Partnern war für diesen Prozess essenziell. Nicht nur in der Planung und Ausstattung der Räumlichkeiten, sondern auch in der Entwicklung von Studienprotokollen und zur kritischen Diskussion von Ergebnissen ist der Aufbau eines Netzwerkes von großer Bedeutung. Durch die Etablierung der experimentellen Gefäßchirurgie Innsbruck ist nun die Realisierung von Projekten der Grundlagenforschung und der translationalen Forschung an diesem universitären Standort möglich. Zudem spielt die Lehrforschung eine immer größere Rolle, insbesondere um die Ausbildungsstruktur möglichst praxisnah zu gestalten, Nachwuchs anzuwerben und die immer komplexer werdenden Techniken auch praxisnah zu vermitteln.
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Affiliation(s)
- Alexandra Gratl
- Univ.-Klinik für Gefäßchirurgie, Medizinische Universität Innsbruck, Anichstraße 35, 6020 Innsbruck, Österreich
| | - Daniela Lobenwein
- Univ.-Klinik für Gefäßchirurgie, Medizinische Universität Innsbruck, Anichstraße 35, 6020 Innsbruck, Österreich
| | - Maria Gummerer
- Univ.-Klinik für Gefäßchirurgie, Medizinische Universität Innsbruck, Anichstraße 35, 6020 Innsbruck, Österreich
| | - Sabine Wipper
- Univ.-Klinik für Gefäßchirurgie, Medizinische Universität Innsbruck, Anichstraße 35, 6020 Innsbruck, Österreich
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