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Xi C, Palani C, Takezaki M, Shi H, Horuzsko A, Pace BS, Zhu X. Simvastatin-Mediated Nrf2 Activation Induces Fetal Hemoglobin and Antioxidant Enzyme Expression to Ameliorate the Phenotype of Sickle Cell Disease. Antioxidants (Basel) 2024; 13:337. [PMID: 38539870 PMCID: PMC10968127 DOI: 10.3390/antiox13030337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/26/2024] [Accepted: 03/08/2024] [Indexed: 06/04/2024] Open
Abstract
Sickle cell disease (SCD) is a pathophysiological condition of chronic hemolysis, oxidative stress, and elevated inflammation. The transcription factor Nrf2 is a master regulator of oxidative stress. Here, we report that the FDA-approved oral agent simvastatin, an inhibitor of hydroxymethyl-glutaryl coenzyme A reductase, significantly activates the expression of Nrf2 and antioxidant enzymes. Simvastatin also induces fetal hemoglobin expression in SCD patient primary erythroid progenitors and a transgenic mouse model. Simvastatin alleviates SCD symptoms by decreasing hemoglobin S sickling, oxidative stress, and inflammatory stress in erythroblasts. Particularly, simvastatin increases cellular levels of cystine, the precursor for the biosynthesis of the antioxidant reduced glutathione, and decreases the iron content in SCD mouse spleen and liver tissues. Mechanistic studies suggest that simvastatin suppresses the expression of the critical histone methyltransferase enhancer of zeste homolog 2 to reduce both global and gene-specific histone H3 lysine 27 trimethylation. These chromatin structural changes promote the assembly of transcription complexes to fetal γ-globin and antioxidant gene regulatory regions in an antioxidant response element-dependent manner. In summary, our findings suggest that simvastatin activates fetal hemoglobin and antioxidant protein expression, modulates iron and cystine/reduced glutathione levels to improve the phenotype of SCD, and represents a therapeutic strategy for further development.
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Affiliation(s)
- Caixia Xi
- Department of Pediatrics, Division of Hematology/Oncology, Augusta University, Augusta, GA 30912, USA; (C.X.); (C.P.)
- Georgia Cancer Center, Augusta University, Augusta, GA 30912, USA (A.H.)
| | - Chithra Palani
- Department of Pediatrics, Division of Hematology/Oncology, Augusta University, Augusta, GA 30912, USA; (C.X.); (C.P.)
| | - Mayuko Takezaki
- Department of Pediatrics, Division of Hematology/Oncology, Augusta University, Augusta, GA 30912, USA; (C.X.); (C.P.)
| | - Huidong Shi
- Georgia Cancer Center, Augusta University, Augusta, GA 30912, USA (A.H.)
| | - Anatolij Horuzsko
- Georgia Cancer Center, Augusta University, Augusta, GA 30912, USA (A.H.)
| | - Betty S. Pace
- Department of Pediatrics, Division of Hematology/Oncology, Augusta University, Augusta, GA 30912, USA; (C.X.); (C.P.)
- Georgia Cancer Center, Augusta University, Augusta, GA 30912, USA (A.H.)
| | - Xingguo Zhu
- Department of Pediatrics, Division of Hematology/Oncology, Augusta University, Augusta, GA 30912, USA; (C.X.); (C.P.)
- Georgia Cancer Center, Augusta University, Augusta, GA 30912, USA (A.H.)
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Chaptal MC, Maraninchi M, Musto G, Mancini J, Chtioui H, Dupont-Roussel J, Marlinge M, Fromonot J, Lalevee N, Mourre F, Beliard S, Guieu R, Valero R, Mottola G. Low Density Lipoprotein Cholesterol Decreases the Expression of Adenosine A 2A Receptor and Lipid Rafts-Protein Flotillin-1: Insights on Cardiovascular Risk of Hypercholesterolemia. Cells 2024; 13:488. [PMID: 38534331 DOI: 10.3390/cells13060488] [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: 12/22/2023] [Revised: 02/26/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
High blood levels of low-density lipoprotein (LDL)-cholesterol (LDL-C) are associated with atherosclerosis, mainly by promoting foam cell accumulation in vessels. As cholesterol is an essential component of cell plasma membranes and a regulator of several signaling pathways, LDL-C excess may have wider cardiovascular toxicity. We examined, in untreated hypercholesterolemia (HC) patients, selected regardless of the cause of LDL-C accumulation, and in healthy participants (HP), the expression of the adenosine A2A receptor (A2AR), an anti-inflammatory and vasodilatory protein with cholesterol-dependent modulation, and Flotillin-1, protein marker of cholesterol-enriched plasma membrane domains. Blood cardiovascular risk and inflammatory biomarkers were measured. A2AR and Flotillin-1 expression in peripheral blood mononuclear cells (PBMC) was lower in patients compared to HP and negatively correlated to LDL-C blood levels. No other differences were observed between the two groups apart from transferrin and ferritin concentrations. A2AR and Flotillin-1 proteins levels were positively correlated in the whole study population. Incubation of HP PBMCs with LDL-C caused a similar reduction in A2AR and Flotillin-1 expression. We suggest that LDL-C affects A2AR expression by impacting cholesterol-enriched membrane microdomains. Our results provide new insights into the molecular mechanisms underlying cholesterol toxicity, and may have important clinical implication for assessment and treatment of cardiovascular risk in HC.
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Affiliation(s)
- Marie-Charlotte Chaptal
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
| | - Marie Maraninchi
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
| | - Giorgia Musto
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
- Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
| | - Julien Mancini
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
| | - Hedi Chtioui
- Department of Nutrition, Metabolic Diseases and Endocrinology, Hospital La Conception, APHM, 13005 Marseille, France
| | - Janine Dupont-Roussel
- Department of Nutrition, Metabolic Diseases and Endocrinology, Hospital La Conception, APHM, 13005 Marseille, France
| | - Marion Marlinge
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
- Secteur de Biochimie, Biogenopôle, Hôpital de la Timone, APHM, 13005 Marseille, France
| | - Julien Fromonot
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
- Secteur de Biochimie, Biogenopôle, Hôpital de la Timone, APHM, 13005 Marseille, France
| | - Nathalie Lalevee
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
| | - Florian Mourre
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
- Department of Nutrition, Metabolic Diseases and Endocrinology, Hospital La Conception, APHM, 13005 Marseille, France
| | - Sophie Beliard
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
- Department of Nutrition, Metabolic Diseases and Endocrinology, Hospital La Conception, APHM, 13005 Marseille, France
| | - Régis Guieu
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
- Secteur de Biochimie, Biogenopôle, Hôpital de la Timone, APHM, 13005 Marseille, France
| | - René Valero
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
- Department of Nutrition, Metabolic Diseases and Endocrinology, Hospital La Conception, APHM, 13005 Marseille, France
| | - Giovanna Mottola
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
- Secteur de Biochimie, Biogenopôle, Hôpital de la Timone, APHM, 13005 Marseille, France
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Ahn J, Lee S, Won S. Possible link between statin and iron deficiency anemia: A South Korean nationwide population-based cohort study. SCIENCE ADVANCES 2023; 9:eadg6194. [PMID: 37889968 PMCID: PMC10610901 DOI: 10.1126/sciadv.adg6194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023]
Abstract
An extensive evaluation of disease occurrence after statin use based on a "hypothesis-free" approach remains scarce. To examine the effect of statin use on the potential risk of developing diseases, a propensity score-matched cohort study was executed using data from the National Sample Cohort in South Korea. A total of 7847 statin users and 39,235 nonstatin users were included in the final analysis. The period of statin use was defined as our main time-dependent exposure and was divided into three periods: current, recent, and past. The main outcomes were defined as new-onset diseases with ≥100 events based on the International Statistical Classification of Diseases, 10th Revision. We calculated the adjusted hazard ratios and 95% confidence intervals (CIs) using Cox regression. We found that statin use significantly increased the risk of developing iron deficiency anemia up to 5.04 times (95% CI, 2.11 to 12.03). Therefore, the iron levels of patients using statins should be monitored carefully.
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Affiliation(s)
- Juhee Ahn
- Department of Public Health Science, Seoul National University, Seoul, Republic of Korea
| | - Sanghun Lee
- Department of Bioconvergence Engineering, Dankook University, Gyeonggi-do, Republic of Korea
- NH Institute for Natural Product Research, Myungji Hospital, Ilsan, Republic of Korea
| | - Sungho Won
- Department of Public Health Science, Seoul National University, Seoul, Republic of Korea
- Interdisciplinary Program of Bioinformatics, Seoul National University, Seoul, Republic of Korea
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
- RexSoft Inc, Seoul, Republic of Korea
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Wang H, Qi Q, Song S, Zhang D, Feng L. Association between soluble transferrin receptor and systolic hypertension in adults: National Health and Nutrition Examination Survey (2007–2010 and 2015–2018). Front Cardiovasc Med 2022; 9:1029714. [PMID: 36407469 PMCID: PMC9671951 DOI: 10.3389/fcvm.2022.1029714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Hypertension increases the global burden of disease and mortality. Iron metabolism is considered to be an important factor in hypertension. However, as an indicator of iron metabolism, little is known about the associations of soluble transferrin receptor (sTfR) with hypertension. We studied the relationship between sTfR and hypertension. Materials and methods We studied 7,416 adults aged 20 years old or above from the National Health and Nutrition Examination Survey (NHANES), a nationally representative, cross-sectional, population-based study. Weighted logistic regression was used to examine the association between markers of iron metabolism and hypertension. The restricted cubic spline (RCS) was used to characterize the association between sTfR and blood pressure. Results Weighted logistic regression showed that higher sTfR level was associated with higher odds of hypertension (OR = 1.05; 95% CI: 1.01–1.05; p = 0.001) after adjustment for all the potential confounding factors. Meanwhile, weighted logistic regression analyses indicated independent associations of high sTfR (p = 0.009) with systolic hypertension after adjusting for various different confounders. The result of restricted cubic splines showed a non-linear association between sTfR and systolic blood pressure among U.S. adults. Conclusion Soluble transferrin receptor was found to be an independent factor in systolic hypertension. And, a non-linear relationship between sTfR and systolic blood pressure was discovered.
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Affiliation(s)
- Haoran Wang
- Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Qianjin Qi
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Shuaihua Song
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Di Zhang
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Li Feng
- Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Clinical Nutrition, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- *Correspondence: Li Feng,
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