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Shahzadi I, Zwanenburg A, Frohwein LJ, Schramm D, Meyer HJ, Hinnerichs M, Moenninghoff C, Niehoff JH, Kroeger JR, Borggrefe J, Surov A. Short-term mortality prediction in acute pulmonary embolism: Radiomics values of skeletal muscle and intramuscular adipose tissue. J Cachexia Sarcopenia Muscle 2024; 15:1430-1440. [PMID: 38859660 PMCID: PMC11294025 DOI: 10.1002/jcsm.13488] [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: 11/03/2023] [Revised: 03/08/2024] [Accepted: 03/22/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Acute pulmonary embolism (APE) is a potentially life-threatening disorder, emphasizing the importance of accurate risk stratification and survival prognosis. The exploration of imaging biomarkers that can reflect patient survival holds the potential to further enhance the stratification of APE patients, enabling personalized treatment and early intervention. Therefore, in this study, we develop computed tomography pulmonary angiography (CTPA) radiomic signatures for the prognosis of 7- and 30-day all-cause mortality in patients with APE. METHODS Diagnostic CTPA images from 829 patients with APE were collected. Two hundred thirty-four features from each skeletal muscle (SM), intramuscular adipose tissue (IMAT) and both tissues combined (SM + IMAT) were calculated at the level of thoracic vertebra 12. Radiomic signatures were derived using 10 times repeated three-fold cross-validation on the training data for SM, IMAT and SM + IMAT for predicting 7- and 30-day mortality independently. The performance of the radiomic signatures was then evaluated on held-out test data and compared with the simplified pulmonary embolism severity index (sPESI) score, a well-established biomarker for risk stratification in APE. Predictive accuracy was assessed by the area under the receiver operating characteristic curve (AUC) with a 95% confidence interval (CI), sensitivity and specificity. RESULTS The radiomic signatures based on IMAT and a combination of SM and IMAT (SM + IMAT) achieved moderate performance for the prediction of 30-day mortality on test data (IMAT: AUC = 0.68, 95% CI [0.57-0.78], sensitivity = 0.57, specificity = 0.73; SM + IMAT: AUC = 0.70, 95% CI [0.60-0.79], sensitivity = 0.74, specificity = 0.54). Radiomic signatures developed for predicting 7-day all-cause mortality showed overall low performance. The clinical signature, that is, sPESI, achieved slightly better performance in terms of AUC on test data compared with the radiomic signatures for the prediction of both 7- and 30-day mortality on the test data (7 days: AUC = 0.73, 95% CI [0.67-0.79], sensitivity = 0.92, specificity = 0.16; 30 days: AUC = 0.74, 95% CI [0.66-0.82], sensitivity = 0.97, specificity = 0.16). CONCLUSIONS We developed and tested radiomic signatures for predicting 7- and 30-day all-cause mortality in APE using a multicentric retrospective dataset. The present multicentre work shows that radiomics parameters extracted from SM and IMAT can predict 30-day all-cause mortality in patients with APE.
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Affiliation(s)
- Iram Shahzadi
- Department of Radiology, Neuroradiology and Nuclear MedicineJohannes Wesling University Hospital, Ruhr University BochumBochumGermany
- Siemens Healthineers GmbHErlangenGermany
| | - Alex Zwanenburg
- OncoRay‐National Center for Radiation Research in Oncology, Faculty of Medicine, and University Hospital Carl Gustav CarusTechnische Universität Dresden, Helmholtz‐Zentrum Dresden‐RossendorfDresdenGermany
- National Center for Tumor Diseases (NCT), Partner Site DresdenDresdenGermany
| | | | | | | | | | - Christoph Moenninghoff
- Department of Radiology, Neuroradiology and Nuclear MedicineJohannes Wesling University Hospital, Ruhr University BochumBochumGermany
| | - Julius Henning Niehoff
- Department of Radiology, Neuroradiology and Nuclear MedicineJohannes Wesling University Hospital, Ruhr University BochumBochumGermany
| | - Jan Robert Kroeger
- Department of Radiology, Neuroradiology and Nuclear MedicineJohannes Wesling University Hospital, Ruhr University BochumBochumGermany
| | - Jan Borggrefe
- Department of Radiology, Neuroradiology and Nuclear MedicineJohannes Wesling University Hospital, Ruhr University BochumBochumGermany
| | - Alexey Surov
- Department of Radiology, Neuroradiology and Nuclear MedicineJohannes Wesling University Hospital, Ruhr University BochumBochumGermany
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Scott NJA, Prickett TCR, Charles CJ, Espiner EA, Richards AM, Rademaker MT. Haemodynamic, hormonal and renal actions of osteocrin in normal sheep. Exp Physiol 2024; 109:1305-1316. [PMID: 38890799 PMCID: PMC11291853 DOI: 10.1113/ep091826] [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: 02/14/2024] [Accepted: 05/20/2024] [Indexed: 06/20/2024]
Abstract
Osteocrin (OSTN) is an endogenous protein sharing structural similarities with the natriuretic peptides [NPs; atrial (ANP), B-type (BNP) and C-type (CNP) NP], which are hormones known for their crucial role in maintaining pressure/volume homeostasis. Osteocrin competes with the NPs for binding to the receptor involved in their clearance (NPR-C). In the present study, having identified, for the first time, the major circulating form of OSTN in human and ovine plasma, we examined the integrated haemodynamic, endocrine and renal effects of vehicle-controlled incremental infusions of ovine proOSTN (83-133) and its metabolism in eight conscious normal sheep. Incremental i.v. doses of OSTN produced stepwise increases in circulating concentrations of the peptide, and its metabolic clearance rate was inversely proportional to the dose. Osteocrin increased plasma levels of ANP, BNP and CNP in a dose-dependent manner, together with concentrations of their intracellular second messenger, cGMP. Increases in plasma cGMP were associated with progressive reductions in arterial pressure and central venous pressure. Plasma cAMP, renin and aldosterone were unchanged. Despite significant increases in urinary cGMP levels, OSTN administration was not associated with natriuresis or diuresis in normal sheep. These results support OSTN as an endogenous ligand for NPR-C in regulating plasma concentrations of NPs and associated cGMP-mediated bioactivity. Collectively, our findings support a role for OSTN in maintaining cardiovascular homeostasis.
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Affiliation(s)
- Nicola J. A. Scott
- Department of Medicine, Christchurch Heart InstituteUniversity of Otago ChristchurchChristchurchNew Zealand
| | - Timothy C. R. Prickett
- Department of Medicine, Christchurch Heart InstituteUniversity of Otago ChristchurchChristchurchNew Zealand
| | - Christopher J. Charles
- Department of Medicine, Christchurch Heart InstituteUniversity of Otago ChristchurchChristchurchNew Zealand
| | - Eric A. Espiner
- Department of Medicine, Christchurch Heart InstituteUniversity of Otago ChristchurchChristchurchNew Zealand
| | - A. Mark Richards
- Department of Medicine, Christchurch Heart InstituteUniversity of Otago ChristchurchChristchurchNew Zealand
- Cardiovascular Research Institute, National University Health SystemsCentre for Translational MedicineSingaporeSingapore
| | - Miriam T. Rademaker
- Department of Medicine, Christchurch Heart InstituteUniversity of Otago ChristchurchChristchurchNew Zealand
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Berezin OO, Berezina TA, Hoppe UC, Lichtenauer M, Berezin AE. Diagnostic and predictive abilities of myokines in patients with heart failure. ADVANCES IN PROTEIN CHEMISTRY AND STRUCTURAL BIOLOGY 2024; 142:45-98. [PMID: 39059994 DOI: 10.1016/bs.apcsb.2023.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
Myokines are defined as a heterogenic group of numerous cytokines, peptides and metabolic derivates, which are expressed, synthesized, produced, and released by skeletal myocytes and myocardial cells and exert either auto- and paracrine, or endocrine effects. Previous studies revealed that myokines play a pivotal role in mutual communications between skeletal muscles, myocardium and remote organs, such as brain, vasculature, bone, liver, pancreas, white adipose tissue, gut, and skin. Despite several myokines exert complete divorced biological effects mainly in regulation of skeletal muscle hypertrophy, residential cells differentiation, neovascularization/angiogenesis, vascular integrity, endothelial function, inflammation and apoptosis/necrosis, attenuating ischemia/hypoxia and tissue protection, tumor growth and malignance, for other occasions, their predominant effects affect energy homeostasis, glucose and lipid metabolism, adiposity, muscle training adaptation and food behavior. Last decade had been identified 250 more myokines, which have been investigating for many years further as either biomarkers or targets for heart failure management. However, only few myokines have been allocated to a promising tool for monitoring adverse cardiac remodeling, ischemia/hypoxia-related target-organ dysfunction, microvascular inflammation, sarcopenia/myopathy and prediction for poor clinical outcomes among patients with HF. This we concentrate on some most plausible myokines, such as myostatin, myonectin, brain-derived neurotrophic factor, muslin, fibroblast growth factor 21, irisin, leukemia inhibitory factor, developmental endothelial locus-1, interleukin-6, nerve growth factor and insulin-like growth factor-1, which are suggested to be useful biomarkers for HF development and progression.
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Affiliation(s)
- Oleksandr O Berezin
- Luzerner Psychiatrie AG, Department of Senior Psychiatrie, St. Urban, Switzerland
| | - Tetiana A Berezina
- Department of Internal Medicine and Nephrology, VitaCenter, Zaporozhye, Ukraine
| | - Uta C Hoppe
- Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, Salzburg, Austria
| | - Michael Lichtenauer
- Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, Salzburg, Austria
| | - Alexander E Berezin
- Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, Salzburg, Austria.
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Jin L, Diaz-Canestro C, Wang Y, Tse MA, Xu A. Exerkines and cardiometabolic benefits of exercise: from bench to clinic. EMBO Mol Med 2024; 16:432-444. [PMID: 38321233 PMCID: PMC10940599 DOI: 10.1038/s44321-024-00027-z] [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: 10/13/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/08/2024] Open
Abstract
Regular exercise has both immediate and long-lasting benefits on cardiometabolic health, and has been recommended as a cornerstone of treatment in the management of diabetes and cardiovascular conditions. Exerkines, which are defined as humoral factors responsive to acute or chronic exercise, have emerged as important players conferring some of the multiple cardiometabolic benefits of exercise. Over the past decades, hundreds of exerkines released from skeletal muscle, heart, liver, adipose tissue, brain, and gut have been identified, and several exerkines (such as FGF21, IL-6, and adiponectin) have been exploited therapeutically as exercise mimetics for the treatment of various metabolic and cardiovascular diseases. Recent advances in metagenomics have led to the identification of gut microbiota, a so-called "hidden" metabolic organ, as an additional class of exerkines determining the efficacy of exercise in diabetes prevention, cardiac protection, and exercise performance. Furthermore, multiomics-based studies have shown the feasibility of using baseline exerkine signatures to predict individual responses to exercise with respect to metabolic and cardiorespiratory health. This review aims to explore the molecular pathways whereby exerkine networks mediate the cardiometabolic adaptations to exercise by fine-tuning inter-organ crosstalk, and discuss the roadmaps for translating exerkine-based discovery into the therapeutic application and personalized medicine in the management of the cardiometabolic disease.
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Affiliation(s)
- Leigang Jin
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong, China
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Candela Diaz-Canestro
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong, China
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yu Wang
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong, China
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China
| | - Michael Andrew Tse
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong, China
- Centre for Sports and Exercise, The University of Hong Kong, Hong Kong, China
| | - Aimin Xu
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong, China.
- Department of Medicine, The University of Hong Kong, Hong Kong, China.
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China.
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Ataka K, Asakawa A, Iwai H, Kato I. Musclin prevents depression-like behavior in male mice by activating urocortin 2 signaling in the hypothalamus. Front Endocrinol (Lausanne) 2023; 14:1288282. [PMID: 38116320 PMCID: PMC10728487 DOI: 10.3389/fendo.2023.1288282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/09/2023] [Indexed: 12/21/2023] Open
Abstract
Introduction Physical activity is recommended as an alternative treatment for depression. Myokines, which are secreted from skeletal muscles during physical activity, play an important role in the skeletal muscle-brain axis. Musclin, a newly discovered myokine, exerts physical endurance, however, the effects of musclin on emotional behaviors, such as depression, have not been evaluated. This study aimed to access the anti-depressive effect of musclin and clarify the connection between depression-like behavior and hypothalamic neuropeptides in mice. Methods We measured the immobility time in the forced swim (FS) test, the time spent in open arm in the elevated-plus maze (EPM) test, the mRNA levels of hypothalamic neuropeptides, and enumerated the c-Fos-positive cells in the paraventricular nucleus (PVN), arcuate nucleus (ARC), and nucleus tractus solitarii (NTS) in mice with the intraperitoneal (i.p.) administration of musclin. Next, we evaluated the effects of a selective corticotropin-releasing factor (CRF) type 1 receptor antagonist, selective CRF type 2 receptor antagonist, melanocortin receptor (MCR) agonist, and selective melanocortin 4 receptor (MC4R) agonist on changes in behaviors induced by musclin. Finally we evaluated the antidepressant effect of musclin using mice exposed to repeated water immersion (WI) stress. Results We found that the i.p. and i.c.v. administration of musclin decreased the immobility time and relative time in the open arms (open %) in mice and increased urocortin 2 (Ucn 2) levels but decreased proopiomelanocortin levels in the hypothalamus. The numbers of c-Fos-positive cells were increased in the PVN and NTS but decreased in the ARC of mice with i.p. administration of musclin. The c-Fos-positive cells in the PVN were also found to be Ucn 2-positive. The antidepressant and anxiogenic effects of musclin were blocked by central administration of a CRF type 2 receptor antagonist and a melanocortin 4 receptor agonist, respectively. Peripheral administration of musclin also prevented depression-like behavior and the decrease in levels of hypothalamic Ucn 2 induced by repeated WI stress. Discussion These data identify the antidepressant effects of musclin through the activation of central Ucn 2 signaling and suggest that musclin and Ucn 2 can be new therapeutic targets and endogenous peptides mediating the muscle-brain axis.
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Affiliation(s)
- Koji Ataka
- Laboratory of Medical Biochemistry, Kobe Pharmaceutical University, Kobe, Japan
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Akihiro Asakawa
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Haruki Iwai
- Department of Oral Anatomy and Cell Biology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ikuo Kato
- Laboratory of Medical Biochemistry, Kobe Pharmaceutical University, Kobe, Japan
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