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van Dijk MJ, Ruiter TJJ, van der Veen S, Rab MAE, van Oirschot BA, Bos J, Derichs C, Rijneveld AW, Cnossen MH, Nur E, Biemond BJ, Bartels M, Schutgens REG, van Solinge WW, Jans JJM, van Beers EJ, van Wijk R. Metabolic blood profile and response to treatment with the pyruvate kinase activator mitapivat in patients with sickle cell disease. Hemasphere 2024; 8:e109. [PMID: 38919958 PMCID: PMC11196954 DOI: 10.1002/hem3.109] [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: 01/30/2024] [Revised: 04/10/2024] [Accepted: 05/01/2024] [Indexed: 06/27/2024] Open
Abstract
Mitapivat is an investigational, oral, small-molecule allosteric activator of pyruvate kinase (PK). PK is a regulatory glycolytic enzyme that is key in providing the red blood cell (RBC) with sufficient amounts of adenosine triphosphate (ATP). In sickle cell disease (SCD), decreased 2,3-DPG levels increase the oxygen affinity of hemoglobin, thereby preventing deoxygenation and polymerization of sickle hemoglobin. The PK activator mitapivat has been shown to decrease levels of 2,3-DPG and increase levels of ATP in RBCs in patients with SCD. In this phase 2, investigator-initiated, open-label study (https://www.clinicaltrialsregister.eu/ NL8517; EudraCT 2019-003438-18), untargeted metabolomics was used to explore the overall metabolic effects of 8-week treatment with mitapivat in the dose-finding period. In total, 1773 unique metabolites were identified in dried blood spots of whole blood from ten patients with SCD and 42 healthy controls (HCs). The metabolic phenotype of patients with SCD revealed alterations in 139/1773 (7.8%) metabolites at baseline when compared to HCs (false discovery rate-adjusted p < 0.05), including increases of (derivatives of) polyamines, purines, and acyl carnitines. Eight-week treatment with mitapivat in nine patients with SCD altered 85/1773 (4.8%) of the total metabolites and 18/139 (12.9%) of the previously identified altered metabolites in SCD (unadjusted p < 0.05). Effects were observed on a broad spectrum of metabolites and were not limited to glycolytic intermediates. Our results show the relevance of metabolic profiling in SCD, not only to unravel potential pathophysiological pathways and biomarkers in multisystem diseases but also to determine the effect of treatment.
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Affiliation(s)
- Myrthe J. van Dijk
- Center for Benign Hematology, Thrombosis and Hemostasis—Van CreveldkliniekUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
- Central Diagnostic Laboratory and ResearchUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Titine J. J. Ruiter
- Central Diagnostic Laboratory and ResearchUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
- Section Metabolic Diagnostics, Department of GeneticsUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Sigrid van der Veen
- Center for Benign Hematology, Thrombosis and Hemostasis—Van CreveldkliniekUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
- Section Metabolic Diagnostics, Department of GeneticsUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Minke A. E. Rab
- Central Diagnostic Laboratory and ResearchUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
- Department of Hematology, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Brigitte A. van Oirschot
- Central Diagnostic Laboratory and ResearchUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Jennifer Bos
- Central Diagnostic Laboratory and ResearchUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Cleo Derichs
- Center for Benign Hematology, Thrombosis and Hemostasis—Van CreveldkliniekUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Anita W. Rijneveld
- Department of Hematology, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Marjon H. Cnossen
- Department of Pediatric Hematology, Erasmus MC Sophia Children's HospitalUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Erfan Nur
- Department of HematologyAmsterdam University Medical Center, University of AmsterdamAmsterdamThe Netherlands
- Department of Blood Cell Research, Sanquin ResearchAmsterdamThe Netherlands
| | - Bart J. Biemond
- Department of HematologyAmsterdam University Medical Center, University of AmsterdamAmsterdamThe Netherlands
| | - Marije Bartels
- Center for Benign Hematology, Thrombosis and Hemostasis—Van CreveldkliniekUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Roger E. G. Schutgens
- Center for Benign Hematology, Thrombosis and Hemostasis—Van CreveldkliniekUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Wouter W. van Solinge
- Central Diagnostic Laboratory and ResearchUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Judith J. M. Jans
- Section Metabolic Diagnostics, Department of GeneticsUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Eduard J. van Beers
- Center for Benign Hematology, Thrombosis and Hemostasis—Van CreveldkliniekUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Richard van Wijk
- Central Diagnostic Laboratory and ResearchUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
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2
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Allison RL, Welby E, Ehlers V, Burand A, Isaeva O, Nieves Torres D, Highland J, Brandow AM, Stucky CL, Ebert AD. Sickle cell disease iPSC-derived sensory neurons exhibit increased excitability and sensitization to patient plasma. Blood 2024; 143:2037-2052. [PMID: 38427938 PMCID: PMC11143522 DOI: 10.1182/blood.2023022591] [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: 09/18/2023] [Revised: 01/25/2024] [Accepted: 02/14/2024] [Indexed: 03/03/2024] Open
Abstract
ABSTRACT Individuals living with sickle cell disease (SCD) experience severe recurrent acute and chronic pain. Challenges to gaining mechanistic insight into pathogenic SCD pain processes include differential gene expression and function of sensory neurons between humans and mice with SCD, and extremely limited availability of neuronal tissues from patients with SCD. Here, we used induced pluripotent stem cells (iPSCs), derived from patients with SCD, differentiated into sensory neurons (SCD iSNs) to begin to overcome these challenges. We characterize key gene expression and function of SCD iSNs to establish a model to investigate intrinsic and extrinsic factors that may contribute to SCD pain. Despite similarities in receptor gene expression, SCD iSNs show pronounced excitability using patch clamp electrophysiology. Furthermore, we find that plasma taken from patients with SCD during acute pain associated with a vaso-occlusive event increases the calcium responses to the nociceptive stimulus capsaicin in SCD iSNs compared with those treated with paired plasma from patients with SCD at steady state baseline or healthy control plasma samples. We identified high levels of the polyamine spermine in baseline and acute pain states of plasma from patients with SCD, which sensitizes SCD iSNs to subthreshold concentrations of capsaicin. Together, these data identify potential intrinsic mechanisms within SCD iSNs that may extend beyond a blood-based pathology.
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Affiliation(s)
- Reilly L. Allison
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI
| | - Emily Welby
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI
| | - Vanessa Ehlers
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI
| | - Anthony Burand
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI
| | - Olena Isaeva
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI
| | - Damaris Nieves Torres
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI
| | - Janelle Highland
- Department of Pediatrics, Section of Hematology/Oncology/Bone Marrow Transplantation, Medical College of Wisconsin, Milwaukee, WI
| | - Amanda M. Brandow
- Department of Pediatrics, Section of Hematology/Oncology/Bone Marrow Transplantation, Medical College of Wisconsin, Milwaukee, WI
| | - Cheryl L. Stucky
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI
| | - Allison D. Ebert
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI
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3
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Alp G, Oztas Y, Yalcinkaya A, Ozel S, Yildirim N, Unal S. Plasma sphingolipids in patients with sickle cell disease: Multiple-site vaso-occlusive crises could be associated with lower sphingolipid levels. Lipids 2024; 59:75-82. [PMID: 38332401 DOI: 10.1002/lipd.12389] [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: 09/01/2023] [Revised: 01/11/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Abstract
Although sickle cell disease (SCD) and its manifestations have been associated with various lipid alterations, there are a few studies exploring the impact of sphingolipids in SCD. In this study, we determined plasma ceramide (Cer) and sphingomyelin (CerPCho) species and investigated their association with the crisis in SCD. SCD patients (N = 27) suffering from vaso-occlusive crisis (VOC) or acute chest syndrome (ACS) were involved in this study. Blood samples were drawn at crisis and later at steady state periods. Clinical history, white blood cell count (WBC), C-reactive protein and lactate dehydrogenase (LDH) levels were recorded. 16:0, 18:0, 20:0, 22:0 Cer and 16:0, 18:0, 24:0 CerPCho were measured via LC-MS/MS. All measured Cer and CerPCho levels of SCD patients at crisis and steady-state were found to be similar. Inflammation-related parameters were significantly higher in patients with ACS compared to single-site VOC. Patients with multiple-site VOC were found to have significantly lower sphingolipid levels compared with those with single-site VOC, at crisis (16, 18, 24 CerPCho and 18, 22 Cer) and at steady-state (24:0 CerPCho and 18 Cer). Our results show that sphingolipid levels in SCD patients are similar during crisis and at steady state. However, lower sphingolipid levels appear to be associated with the development of multiple-site VOC. Since the differences were observed at both crisis and steady-state, sphingolipid level could be an underlying factor associated with crisis characteristics in patients with SCD.
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Affiliation(s)
- Gokce Alp
- Faculty of Engineering, Department of Chemical Engineering, Hacettepe University, Ankara, Turkey
| | - Yesim Oztas
- Faculty of Medicine, Department of Medical Biochemistry, Hacettepe University, Ankara, Turkey
| | - Ahmet Yalcinkaya
- Faculty of Medicine, Department of Medical Biochemistry, Hacettepe University, Ankara, Turkey
| | - Selinay Ozel
- Faculty of Science, Department of Chemistry, Hacettepe University, Ankara, Turkey
| | - Nazim Yildirim
- Faculty of Medicine, Department of Pediatrics Hematology, Mersin University, Mersin, Turkey
| | - Selma Unal
- Faculty of Medicine, Department of Pediatrics Hematology, Mersin University, Mersin, Turkey
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Khurana K, Mahajan S, Acharya S, Kumar S, Toshniwal S. Clinical Biomarkers of Acute Vaso-Occlusive Sickle Cell Crisis. Cureus 2024; 16:e56389. [PMID: 38633967 PMCID: PMC11022002 DOI: 10.7759/cureus.56389] [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: 01/16/2024] [Accepted: 03/17/2024] [Indexed: 04/19/2024] Open
Abstract
It is known that an inherited blood condition called sickle cell disease (SCD) is a result of one gene. A number of blood and urine biomarkers have been determined in association with lab and clinical history for SCD patients. SCD has numerous interacting pathways associated with it, which have been identified by biomarkers. These mechanisms consist of some examples, such as endothelial vasodilation response, hypercoagulability, hemolysis, inflammation, oxidative stress, vascular dysfunction, and reperfusion injury among others. To effectively manage SCD, a comprehensive panel of validated blood and urine biomarkers must be established. Despite its monogenic inheritance, the complex nature of the SCD phenotype has impeded progress in its treatment. However, significant strides have been made in clinical biotechnology, paving the way for potential breakthroughs. In SCD, a panel of verified blood and urine biomarkers must be established, however. Despite monogenic inheritance, the great complexity of the SCD phenotype has hindered progress in its management. With few exceptions, clinical biomarkers of illness severity have been found through epidemiological investigations; nevertheless, systematic integration of these biomarkers into clinical treatment algorithms has not occurred. Furthermore, sickle cell crisis, the primary acute consequence of SCD, has been difficult to diagnose with the biomarkers now in use. Inadequate care and a lack of appropriate outcome measures for clinical research are the consequences of these diagnostic constraints. A new chapter in SCD customized treatment has begun with recent advancements in molecular and imaging diagnostics. Strategies in precision medicine are especially relevant now that molecular therapies are within reach. The significance of biochemical indicators linked to clinical manifestation and sub-phenotype identification in SCD is reviewed in this research.
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Affiliation(s)
- Kashish Khurana
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Satish Mahajan
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sourya Acharya
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sunil Kumar
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Saket Toshniwal
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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van Dijk MJ, Traets MJM, van Oirschot BA, Ruiter TJJ, de Wilde JRA, Bos J, van Solinge WW, Koziel MJ, Jans JJM, Wani R, van Beers EJ, van Wijk R, Rab MAE. A novel composition of endogenous metabolic modulators improves red blood cell properties in sickle cell disease. EJHAEM 2024; 5:21-32. [PMID: 38406513 PMCID: PMC10887255 DOI: 10.1002/jha2.850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/18/2023] [Accepted: 01/08/2024] [Indexed: 02/27/2024]
Abstract
The most common forms of sickle cell disease (SCD) are sickle cell anemia (SCA; HbSS) and HbSC disease. In both, especially the more dense, dehydrated and adherent red blood cells (RBCs) with reduced deformability are prone to hemolysis and sickling, and thereby vaso-occlusion. Based on plasma amino acid profiling in SCD, a composition of 10 amino acids and derivatives (RCitNacQCarLKHVS; Axcella Therapeutics, USA), referred to as endogenous metabolic modulators (EMMs), was designed to target RBC metabolism. The effects of ex vivo treatment with the EMM composition on different RBC properties were studied in SCD (n = 9 SCA, n = 5 HbSC disease). Dose-dependent improvements were observed in RBC hydration assessed by hemocytometry (MCV, MCHC, dense RBCs) and osmotic gradient ektacytometry (Ohyper). Median (interquartile range [IQR]) increase in Ohyper compared to vehicle was 4.9% (4.0%-5.5%), 7.5% (6.9%-9.4%), and 12.8% (11.5%-14.0%) with increasing 20×, 40×, and 80X concentrations, respectively (all p < 0.0001). RBC deformability (EImax using oxygen gradient ektacytometry) increased by 8.1% (2.2%-12.1%; p = 0.0012), 9.6% (2.9%-15.1%; p = 0.0013), and 13.3% (5.7%-25.5%; p = 0.0007), respectively. Besides, RBC adhesion to subendothelial laminin decreased by 43% (6%-68%; p = 0.4324), 58% (48%-72%; p = 0.0185), and 71% (49%-82%; p = 0.0016), respectively. Together, these results provide a rationale for further studies with the EMM composition targeting multiple RBC properties in SCD.
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Affiliation(s)
- Myrthe J. van Dijk
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
- Center for Benign Hematology, Thrombosis and Hemostasis—Van CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Marissa J. M. Traets
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Brigitte A. van Oirschot
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Titine J. J. Ruiter
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
- Section Metabolic Diagnostics, Department of GeneticsUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Jonathan R. A. de Wilde
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Jennifer Bos
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Wouter W. van Solinge
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | | | - Judith J. M. Jans
- Section Metabolic Diagnostics, Department of GeneticsUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Revati Wani
- Axcella TherapeuticsCambridgeMassachusettsUSA
- Boehringer Ingelheim Pharmaceuticals, Inc.CambridgeMassachusettsUSA
| | - Eduard J. van Beers
- Center for Benign Hematology, Thrombosis and Hemostasis—Van CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Richard van Wijk
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Minke A. E. Rab
- Department of Central Diagnostic Laboratory—Research, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
- Department of HematologyUniversity Medical Center UtrechtUtrechtThe Netherlands
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6
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Khater D, Al-Mulaabed S, Alomairi A, Elshinawy M, Soliman A, Elshinawy N, Wali Y, Al Yaarubi S. Effect of Hydroxyurea Therapy on Growth Parameters in Older Children (6-15 Year-Old) with Sickle Cell Disease: Low Dose Versus High Dose. Hemoglobin 2023; 47:157-162. [PMID: 37691435 DOI: 10.1080/03630269.2023.2254238] [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: 03/21/2023] [Revised: 07/17/2023] [Accepted: 08/17/2023] [Indexed: 09/12/2023]
Abstract
Growth impairment is a known complication of sickle cell disease (SCD). Few studies explored the potential effects of hydroxyurea (HU) on growth in children with SCD in relation to HU dose and response. This is a prospective study conducted at Sultan Qaboos University Hospital, Oman, and included 91 SCD patients with age below 16 years when started on HU, aiming to explore the potential effect/s of HU on growth parameters of older children with SCD in relation to their clinical improvement and the dose required for this improvement. Weight, height, and body mass index (BMI) were collected at baseline, 6 and 18 months after initiation. Anthropometric data were compared to WHO standards. Initial height and BMI Z scores (HAZ and WAZ) were lower compared to WHO norms. HAZ and WAZ did not change significantly after 6 and 18 months on HU therapy. However, BMI Z-scores improved significantly after 6 and 18 months of follow-up (p value 0.044 and 0.028 respectively). No significant changes were observed in WAZ or HAZ among patients on low dose versus those on high dose. BMI Z score improved significantly after 18 months of low dose group (p = 0.014) but did not change in those on high dose HU. In conclusion, HU therapy did not adversely affect weight and height growth in older children with SCD. BMI Z scores improved at 18 months in patients on low dose but not in those on high dose (p = 0.014).
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Affiliation(s)
- Doaa Khater
- Department of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Child Health Department, Sultan Qaboos University Hospital, Muscat, Oman
| | - Sharef Al-Mulaabed
- Department of Pediatrics, Presbyterian Medical Group, Albuquerque, NM, USA
| | - Anwar Alomairi
- Child Health Department, Sultan Qaboos University Hospital, Muscat, Oman
| | - Mohamed Elshinawy
- Department of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Child Health Department, Sultan Qaboos University Hospital, Muscat, Oman
| | - Ashraf Soliman
- Pediatric Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Noor Elshinawy
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Yasser Wali
- Department of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Child Health Department, Sultan Qaboos University Hospital, Muscat, Oman
| | - Saif Al Yaarubi
- Child Health Department, Sultan Qaboos University Hospital, Muscat, Oman
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7
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Dieu X, Tamareille S, Herbreteau A, Lebeau L, Chao De La Barca JM, Chabrun F, Reynier P, Mirebeau-Prunier D, Prunier F. Combined Metabolipidomic and Machine Learning Approach in a Rat Model of Stroke Reveals a Deleterious Impact of Brain Injury on Heart Metabolism. Int J Mol Sci 2023; 24:12000. [PMID: 37569376 PMCID: PMC10418865 DOI: 10.3390/ijms241512000] [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: 05/26/2023] [Revised: 07/07/2023] [Accepted: 07/12/2023] [Indexed: 08/13/2023] Open
Abstract
Cardiac complications are frequently found following a stroke in humans whose pathophysiological mechanism remains poorly understood. We used machine learning to analyse a large set of data from a metabolipidomic study assaying 630 metabolites in a rat stroke model to investigate metabolic changes affecting the heart within 72 h after a stroke. Twelve rats undergoing a stroke and 28 rats undergoing the sham procedure were investigated. A plasmatic signature consistent with the literature with notable lipid metabolism remodelling was identified. The post-stroke heart showed a discriminant metabolic signature, in comparison to the sham controls, involving increased collagen turnover, increased arginase activity with decreased nitric oxide synthase activity as well as an altered amino acid metabolism (including serine, asparagine, lysine and glycine). In conclusion, these results demonstrate that brain injury induces a metabolic remodelling in the heart potentially involved in the pathophysiology of stroke heart syndrome.
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Affiliation(s)
- Xavier Dieu
- MITOVASC, SFR ICAT, CNRS, INSERM, Université d’Angers, F-49000 Angers, France; (S.T.); (A.H.); (L.L.); (J.M.C.D.L.B.); (F.C.); (P.R.); (D.M.-P.); (F.P.)
- Service de Biochimie et Biologie Moléculaire, CHU Angers, F-49000 Angers, France
| | - Sophie Tamareille
- MITOVASC, SFR ICAT, CNRS, INSERM, Université d’Angers, F-49000 Angers, France; (S.T.); (A.H.); (L.L.); (J.M.C.D.L.B.); (F.C.); (P.R.); (D.M.-P.); (F.P.)
| | - Aglae Herbreteau
- MITOVASC, SFR ICAT, CNRS, INSERM, Université d’Angers, F-49000 Angers, France; (S.T.); (A.H.); (L.L.); (J.M.C.D.L.B.); (F.C.); (P.R.); (D.M.-P.); (F.P.)
| | - Lucie Lebeau
- MITOVASC, SFR ICAT, CNRS, INSERM, Université d’Angers, F-49000 Angers, France; (S.T.); (A.H.); (L.L.); (J.M.C.D.L.B.); (F.C.); (P.R.); (D.M.-P.); (F.P.)
| | - Juan Manuel Chao De La Barca
- MITOVASC, SFR ICAT, CNRS, INSERM, Université d’Angers, F-49000 Angers, France; (S.T.); (A.H.); (L.L.); (J.M.C.D.L.B.); (F.C.); (P.R.); (D.M.-P.); (F.P.)
- Service de Biochimie et Biologie Moléculaire, CHU Angers, F-49000 Angers, France
| | - Floris Chabrun
- MITOVASC, SFR ICAT, CNRS, INSERM, Université d’Angers, F-49000 Angers, France; (S.T.); (A.H.); (L.L.); (J.M.C.D.L.B.); (F.C.); (P.R.); (D.M.-P.); (F.P.)
- Service de Biochimie et Biologie Moléculaire, CHU Angers, F-49000 Angers, France
| | - Pascal Reynier
- MITOVASC, SFR ICAT, CNRS, INSERM, Université d’Angers, F-49000 Angers, France; (S.T.); (A.H.); (L.L.); (J.M.C.D.L.B.); (F.C.); (P.R.); (D.M.-P.); (F.P.)
- Service de Biochimie et Biologie Moléculaire, CHU Angers, F-49000 Angers, France
| | - Delphine Mirebeau-Prunier
- MITOVASC, SFR ICAT, CNRS, INSERM, Université d’Angers, F-49000 Angers, France; (S.T.); (A.H.); (L.L.); (J.M.C.D.L.B.); (F.C.); (P.R.); (D.M.-P.); (F.P.)
- Service de Biochimie et Biologie Moléculaire, CHU Angers, F-49000 Angers, France
| | - Fabrice Prunier
- MITOVASC, SFR ICAT, CNRS, INSERM, Université d’Angers, F-49000 Angers, France; (S.T.); (A.H.); (L.L.); (J.M.C.D.L.B.); (F.C.); (P.R.); (D.M.-P.); (F.P.)
- Service de Cardiologie, CHU Angers, F-49000 Angers, France
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8
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D’Alessandro A, Nouraie SM, Zhang Y, Cendali F, Gamboni F, Reisz JA, Zhang X, Bartsch KW, Galbraith MD, Gordeuk VR, Gladwin MT. In vivo evaluation of the effect of sickle cell hemoglobin S, C and therapeutic transfusion on erythrocyte metabolism and cardiorenal dysfunction. Am J Hematol 2023; 98:1017-1028. [PMID: 36971592 PMCID: PMC10272107 DOI: 10.1002/ajh.26923] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/20/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023]
Abstract
Despite a wealth of exploratory plasma metabolomics studies in sickle cell disease (SCD), no study to date has evaluate a large and well phenotyped cohort to compare the primary erythrocyte metabolome of hemoglobin SS, SC and transfused AA red blood cells (RBCs) in vivo. The current study evaluates the RBC metabolome of 587 subjects with sickle cell sickle cell disease (SCD) from the WALK-PHaSST clinical cohort. The set includes hemoglobin SS, hemoglobin SC SCD patients, with variable levels of HbA related to RBC transfusion events. Here we explore the modulating effects of genotype, age, sex, severity of hemolysis, and transfusion therapy on sickle RBC metabolism. Results show that RBCs from patients with Hb SS genotypes-compared to AA RBCs from recent transfusion events or SC RBCs-are characterized by significant alterations of RBC acylcarnitines, pyruvate, sphingosine 1-phosphate, creatinine, kynurenine and urate metabolism. Surprisingly, the RBC metabolism of SC RBCs is dramatically different from SS, with all glycolytic intermediates significantly elevated in SS RBCs, with the exception of pyruvate. This result suggests a metabolic blockade at the ATP-generating phosphoenolpyruvate to pyruvate step of glycolysis, which is catalyzed by redox-sensitive pyruvate kinase. Metabolomics, clinical and hematological data were collated in a novel online portal. In conclusion, we identified metabolic signatures of HbS RBCs that correlate with the degree of steady state hemolytic anemia, cardiovascular and renal dysfunction and mortality.
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Affiliation(s)
- Angelo D’Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver – Anschutz Medical Campus, Aurora, CO, USA
- Department of Medicine – Division of Hematology, University of Colorado Denver – Anschutz Medical Campus, Aurora, CO, USA
| | - S. Mehdi Nouraie
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pennsylvania, USA
| | - Yingze Zhang
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pennsylvania, USA
| | - Francesca Cendali
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver – Anschutz Medical Campus, Aurora, CO, USA
| | - Fabia Gamboni
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver – Anschutz Medical Campus, Aurora, CO, USA
| | - Julie A. Reisz
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver – Anschutz Medical Campus, Aurora, CO, USA
| | - Xu Zhang
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kyle W. Bartsch
- Linda Crnic Institute for Down Syndrome, University of Colorado – Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew D. Galbraith
- Linda Crnic Institute for Down Syndrome, University of Colorado – Anschutz Medical Campus, Aurora, CO, USA
| | - Victor R. Gordeuk
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Mark T Gladwin
- University of Maryland School of Medicine, University of Maryland, Baltimore, MD, USA
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9
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Cendali FI, Nemkov T, Lisk C, Lacroix IS, Nouraie SM, Zhang Y, Gordeuk VR, Buehler PW, Irwin D, D'Alessandro A. Metabolic correlates to critical speed in murine models of sickle cell disease. Front Physiol 2023; 14:1151268. [PMID: 37007990 PMCID: PMC10053510 DOI: 10.3389/fphys.2023.1151268] [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: 01/25/2023] [Accepted: 03/03/2023] [Indexed: 03/16/2023] Open
Abstract
Introduction: Exercise intolerance is a common clinical manifestation in patients with sickle cell disease (SCD), though the mechanisms are incompletely understood. Methods: Here we leverage a murine mouse model of sickle cell disease, the Berkeley mouse, to characterize response to exercise via determination of critical speed (CS), a functional measurement of mouse running speed upon exerting to exhaustion. Results: Upon observing a wide distribution in critical speed phenotypes, we systematically determined metabolic aberrations in plasma and organs-including heart, kidney, liver, lung, and spleen-from mice ranked based on critical speed performances (top vs. bottom 25%). Results indicated clear signatures of systemic and organ-specific alterations in carboxylic acids, sphingosine 1-phosphate and acylcarnitine metabolism. Metabolites in these pathways showed significant correlations with critical speed across all matrices. Findings from murine models were thus further validated in 433 sickle cell disease patients (SS genotype). Metabolomics analyses of plasma from 281 subjects in this cohort (with HbA < 10% to decrease confounding effects of recent transfusion events) were used to identify metabolic correlates to sub-maximal exercise test performances, as measure by 6 min walking test in this clinical cohort. Results confirmed strong correlation between test performances and dysregulated levels of circulating carboxylic acids (especially succinate) and sphingosine 1-phosphate. Discussion: We identified novel circulating metabolic markers of exercise intolerance in mouse models of sickle cell disease and sickle cell patients.
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Affiliation(s)
- Francesca I Cendali
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, CO, United States
| | - Travis Nemkov
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, CO, United States
| | - Christina Lisk
- Department of Pulmonology, University of Colorado Denver, Aurora, CO, United States
| | - Ian S Lacroix
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, CO, United States
| | - Seyed-Mehdi Nouraie
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Yingze Zhang
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Victor R Gordeuk
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Paul W Buehler
- Department of Pathology, University of Maryland, Baltimore, MD, United States
- Center for Blood Oxygen Transport, Department of Pediatrics, Baltimore, MD, United States
| | - David Irwin
- Department of Pulmonology, University of Colorado Denver, Aurora, CO, United States
| | - Angelo D'Alessandro
- Department of Pulmonology, University of Colorado Denver, Aurora, CO, United States
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10
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D'Alessandro A, Nouraie SM, Zhang Y, Cendali F, Gamboni F, Reisz JA, Zhang X, Bartsch KW, Galbraith MD, Gordeuk VR, Gladwin MT. In vivo evaluation of the effect of sickle cell hemoglobin S, C and therapeutic transfusion on erythrocyte metabolism and cardiorenal dysfunction. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.13.528368. [PMID: 36824724 PMCID: PMC9948995 DOI: 10.1101/2023.02.13.528368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Despite a wealth of exploratory plasma metabolomics studies in sickle cell disease (SCD), no study to date has evaluate a large and well phenotyped cohort to compare the primary erythrocyte metabolome of hemoglobin SS, SC and transfused AA red blood cells (RBCs) in vivo . The current study evaluates the RBC metabolome of 587 subjects with sickle cell sickle cell disease (SCD) from the WALK-PHaSST clinical cohort. The set includes hemoglobin SS, hemoglobin SC SCD patients, with variable levels of HbA related to RBC transfusion events, and HbF related to hydroxyurea therapy. Here we explore the modulating effects of genotype, age, sex, severity of hemolysis, and hydroxyurea and transfusion therapy on sickle RBC metabolism. Data - collated in an online portal - show that the Hb SS genotype is associated with significant alterations of RBC acylcarnitines, pyruvate, sphingosine 1-phosphate, creatinine, kynurenine and urate metabolism. Surprisingly, the RBC metabolism of SC RBCs is dramatically different from SS, with all glycolytic intermediates significantly elevated in SS RBCs, with the exception of pyruvate. This result suggests a metabolic blockade at the ATP-generating phosphoenolpyruvate to pyruvate step of glycolysis, which is catalyzed by redox-sensitive pyruvate kinase. Increasing in vivo concentrations of HbA improved glycolytic flux and normalized the HbS erythrocyte metabolome. An unexpectedly limited metabolic effect of hydroxyurea and HbF was observed, possibly related to the modest induction of HbF in this cohort. The metabolic signature of HbS RBCs correlated with the degree of steady state hemolytic anemia, cardiovascular and renal dysfunction and mortality. Key points In vivo dysregulation of RBC metabolism by HbS is evaluated by metabolic profiling of 587 patients with variable HbA, HbC and HbF levels;RBC acyl-carnitines, urate, pyruvate metabolism, S1P, kynurenine relate to hemolysis and cardiorenal dysfunction, respond to transfusion.
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11
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Zhou Y, Yu X, Nicely A, Cunningham G, Challa C, McKinley K, Nickel R, Campbell A, Darbari D, Summar M, Majumdar S. Amino acid signature during sickle cell pain crisis shows significant alterations related to nitric oxide and energy metabolism. Mol Genet Metab 2022; 137:146-152. [PMID: 36030599 DOI: 10.1016/j.ymgme.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/20/2022]
Abstract
Nitric oxide depletion secondary to arginase induced arginine deficiency has been shown to be important in the pathophysiology of vaso-occlusion in sickle cell pain crisis. Our objective of this study was to perform a comprehensive amino acid evaluation during sickle cell pain crisis. In a total of 58 subjects (29 in steady-state sickle cell disease and 29 with sickle cell pain crisis), the amino acids related to nitric oxide pathway was significantly decreased during sickle cell pain crisis compared to steady-state sickle cell disease: arginine (p = 0.001), citrulline (p = 0.012), and ornithine (p = 0.03). In addition, the amino acids related to energy metabolism was significantly decreased during a pain crisis: asparagine (p < 0.001), serine (p = 0.002), histidine (p = 0.017), alanine (p = 0.004), tyrosine (p = 0.012), methionine (p = 0.007), cystine (p = 0.016), isoleucine (p = 0.016) and lysine (p = 0.006). The amino acid related to oxidative stress were significantly higher during a sickle cell pain crisis (glutamic acid (p < 0.001). Furthermore, multivariate analysis with partial least squares-discriminant analysis (PLS-DA) showed that deficiencies of the amino acids arginine, asparagine, citrulline, methionine and alanine were the most important related to sickle cell pain crisis.
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Affiliation(s)
- Yun Zhou
- Divisions of Genetics, Children's National Hospital, George Washington University of Health Sciences, United States of America
| | - Xue Yu
- Department of Data Science, University of Mississippi Medical Center, United States of America
| | - Ava Nicely
- Hematology, Children's National Hospital, George Washington University of Health Sciences, United States of America
| | - Gary Cunningham
- Divisions of Genetics, Children's National Hospital, George Washington University of Health Sciences, United States of America
| | - Chaitanya Challa
- Anesthesia, Children's National Hospital, George Washington University of Health Sciences, United States of America
| | - Kenneth McKinley
- Emergency Department, Children's National Hospital, George Washington University of Health Sciences, United States of America
| | - Robert Nickel
- Hematology, Children's National Hospital, George Washington University of Health Sciences, United States of America
| | - Andrew Campbell
- Hematology, Children's National Hospital, George Washington University of Health Sciences, United States of America
| | - Deepika Darbari
- Hematology, Children's National Hospital, George Washington University of Health Sciences, United States of America
| | - Marshall Summar
- Divisions of Genetics, Children's National Hospital, George Washington University of Health Sciences, United States of America
| | - Suvankar Majumdar
- Hematology, Children's National Hospital, George Washington University of Health Sciences, United States of America.
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12
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Onalo R, Cooper P, Cilliers A, Vorster BC, Uche N, Oluseyi OO, Onalo VD, Zubairu Y, Ayodele‐Kehinde AU, Damilare OM, Figueroa J, Morris CR. Randomized control trial of oral arginine therapy for children with sickle cell anemia hospitalized for pain in Nigeria. Am J Hematol 2021; 96:89-97. [PMID: 33075179 DOI: 10.1002/ajh.26028] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 10/16/2020] [Accepted: 10/17/2020] [Indexed: 12/15/2022]
Abstract
Low arginine bioavailability is associated with vaso-occlusive painful crisis (VOC) severity in sickle cell anemia (SCA) and predicts need for pediatric hospitalization. Intravenous arginine therapy has opioid-sparing effects and was found to significantly decrease pain scores in children hospitalized with SCA-VOC in a phase-two randomized placebo-controlled trial (RCT). Efficacy of oral arginine is unknown. Our objective was to determine the safety and efficacy of oral arginine therapy in Nigerian children with SCA. A double-blind RCT of oral L-arginine-hydrochloride (100 mg/kg TID) was conducted in children with SCA-VOC, aged 5-17 years, hospitalized at two Nigerian sites. The primary outcome measure was analgesic usage, quantified by difference in the mean Analgesic Medication Quantification Scale (MQS). Secondary outcomes included daily pain scores, time-to-crisis-resolution and length-of-hospital-stay. An intention-to-treat analysis was performed. Sixty-eight children (age 5-17 years, mean 10.6 ± 0.4 years; 56% male), were randomized to receive L-arginine (35 patients) or placebo (33 patients). The mean total MQS for the arginine group was 73.4 (95% CI, 62.4-84.3) vs 120.0 (96.7-143.3) for placebo (P < .001). The mean rate of decline in worst pain scores was faster in the arginine arm vs placebo (1.50 [1.23-1.77] vs 1.09 [0.94-1.24] point/d, P = .009). Children receiving arginine had a shorter time-to-crisis-resolution (P = .02), shorter hospital-stay (P = .002) and experienced no serious adverse event. Pain control was more rapid, total analgesic requirement was significantly reduced, and most notably, time-to-crisis-resolution and length-of-hospital-stay were shorter in children with SCA-VOC receiving arginine vs placebo. Given the established safety and low cost, oral arginine is a promising adjuvant therapy for SCA-VOC management.
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Affiliation(s)
- Richard Onalo
- Department of Paediatrics Faculty of Clinical Sciences, University of Abuja Gwagwalada Nigeria
- Department of Paediatrics Faculty of Clinical Sciences, University of the Witwatersrand Johannesburg South Africa
| | - Peter Cooper
- Department of Paediatrics Faculty of Clinical Sciences, University of the Witwatersrand Johannesburg South Africa
| | - Antoinette Cilliers
- Department of Paediatrics Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand Johannesburg South Africa
| | - Barend C. Vorster
- Centre for Human Metabolomics North West University Potchefstroom South Africa
| | - Nnebe‐Agumadu Uche
- Department of Paediatrics Faculty of Clinical Sciences, University of Abuja Gwagwalada Nigeria
| | | | - Victoria D. Onalo
- Emergency Paediatric Pharmacy University of Abuja Teaching Hospital Gwagwalada Nigeria
| | - Yunusa Zubairu
- Emergency Paediatric Pharmacy University of Abuja Teaching Hospital Gwagwalada Nigeria
| | | | | | - Janet Figueroa
- Department of Pediatrics Biostatistical Core, Emory University School of Medicine Atlanta Georgia USA
| | - Claudia R. Morris
- Division of Pediatric Emergency Medicine, Department of Pediatrics Emory University School of Medicine Atlanta Georgia USA
- Childrenʼs Healthcare of Atlanta Atlanta Georgia USA
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13
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Dembélé KC, Mintz T, Veyrat-Durebex C, Chabrun F, Chupin S, Tessier L, Simard G, Henrion D, Mirebeau-Prunier D, Chao de la Barca JM, Tharaux PL, Reynier P. Metabolomic Profiling of Plasma and Erythrocytes in Sickle Mice Points to Altered Nociceptive Pathways. Cells 2020; 9:cells9061334. [PMID: 32466566 PMCID: PMC7349104 DOI: 10.3390/cells9061334] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/21/2020] [Accepted: 05/23/2020] [Indexed: 12/26/2022] Open
Abstract
Few data-driven metabolomic approaches have been reported in sickle cell disease (SCD) to date. We performed a metabo-lipidomic study on the plasma and red blood cells of a steady-state mouse model carrying the homozygous human hemoglobin SS, compared with AS and AA genotypes. Among the 188 metabolites analyzed by a targeted quantitative metabolomic approach, 153 and 129 metabolites were accurately measured in the plasma and red blood cells, respectively. Unsupervised PCAs (principal component analyses) gave good spontaneous discrimination between HbSS and controls, and supervised OPLS-DAs (orthogonal partial least squares-discriminant analyses) provided highly discriminant models. These models confirmed the well-known deregulation of nitric oxide synthesis in the HbSS genotype, involving arginine deficiency and increased levels of dimethylarginines, ornithine, and polyamines. Other discriminant metabolites were newly evidenced, such as hexoses, alpha-aminoadipate, serotonin, kynurenine, and amino acids, pointing to a glycolytic shift and to the alteration of metabolites known to be involved in nociceptive pathways. Sharp remodeling of lysophosphatidylcholines, phosphatidylcholines, and sphingomyelins was evidenced in red blood cells. Our metabolomic study provides an overview of the metabolic remodeling induced by the sickle genotype in the plasma and red blood cells, revealing a biological fingerprint of altered nitric oxide, bioenergetics and nociceptive pathways.
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Affiliation(s)
- Klétigui Casimir Dembélé
- Faculté de Pharmacie, Université des Sciences, des Techniques et des Technologies de Bamako BP, Bamako 1805, Mali;
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (F.C.); (S.C.); (L.T.); (G.S.); (D.M.-P.); (J.M.C.d.l.B.)
- Unité Mixte de Recherche (UMR) MITOVASC, Centre National de la Recherche Scientifique (CNRS) 6015, Institut National de la Santé et de la Recherche Médicale (INSERM) U1083, Université d’Angers, 49933 Angers, France;
| | - Thomas Mintz
- Paris Cardiovascular Centre (PARCC), Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France;
| | - Charlotte Veyrat-Durebex
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1253, Université François Rabelais de Tours, 37000 Tours, France;
- Laboratoire de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire de Tours, 37000 Tours, France
| | - Floris Chabrun
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (F.C.); (S.C.); (L.T.); (G.S.); (D.M.-P.); (J.M.C.d.l.B.)
- Unité Mixte de Recherche (UMR) MITOVASC, Centre National de la Recherche Scientifique (CNRS) 6015, Institut National de la Santé et de la Recherche Médicale (INSERM) U1083, Université d’Angers, 49933 Angers, France;
| | - Stéphanie Chupin
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (F.C.); (S.C.); (L.T.); (G.S.); (D.M.-P.); (J.M.C.d.l.B.)
| | - Lydie Tessier
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (F.C.); (S.C.); (L.T.); (G.S.); (D.M.-P.); (J.M.C.d.l.B.)
| | - Gilles Simard
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (F.C.); (S.C.); (L.T.); (G.S.); (D.M.-P.); (J.M.C.d.l.B.)
| | - Daniel Henrion
- Unité Mixte de Recherche (UMR) MITOVASC, Centre National de la Recherche Scientifique (CNRS) 6015, Institut National de la Santé et de la Recherche Médicale (INSERM) U1083, Université d’Angers, 49933 Angers, France;
| | - Delphine Mirebeau-Prunier
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (F.C.); (S.C.); (L.T.); (G.S.); (D.M.-P.); (J.M.C.d.l.B.)
- Unité Mixte de Recherche (UMR) MITOVASC, Centre National de la Recherche Scientifique (CNRS) 6015, Institut National de la Santé et de la Recherche Médicale (INSERM) U1083, Université d’Angers, 49933 Angers, France;
| | - Juan Manuel Chao de la Barca
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (F.C.); (S.C.); (L.T.); (G.S.); (D.M.-P.); (J.M.C.d.l.B.)
- Unité Mixte de Recherche (UMR) MITOVASC, Centre National de la Recherche Scientifique (CNRS) 6015, Institut National de la Santé et de la Recherche Médicale (INSERM) U1083, Université d’Angers, 49933 Angers, France;
| | - Pierre-Louis Tharaux
- Paris Cardiovascular Centre (PARCC), Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France;
- Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France
- Nephrology Division, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France
- Correspondence: (P.-L.T.); (P.R.)
| | - Pascal Reynier
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (F.C.); (S.C.); (L.T.); (G.S.); (D.M.-P.); (J.M.C.d.l.B.)
- Unité Mixte de Recherche (UMR) MITOVASC, Centre National de la Recherche Scientifique (CNRS) 6015, Institut National de la Santé et de la Recherche Médicale (INSERM) U1083, Université d’Angers, 49933 Angers, France;
- Correspondence: (P.-L.T.); (P.R.)
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