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Williams MJ, Halabi CM, Patel HM, Joseph Z, McCommis K, Weinheimer C, Kovacs A, Lima F, Finck B, Malluche H, Hruska KA. In chronic kidney disease altered cardiac metabolism precedes cardiac hypertrophy. Am J Physiol Renal Physiol 2024; 326:F751-F767. [PMID: 38385175 DOI: 10.1152/ajprenal.00416.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 02/23/2024] Open
Abstract
Conduit arterial disease in chronic kidney disease (CKD) is an important cause of cardiac complications. Cardiac function in CKD has not been studied in the absence of arterial disease. In an Alport syndrome model bred not to have conduit arterial disease, mice at 225 days of life (dol) had CKD equivalent to humans with CKD stage 4-5. Parathyroid hormone (PTH) and FGF23 levels were one log order elevated, circulating sclerostin was elevated, and renal activin A was strongly induced. Aortic Ca levels were not increased, and vascular smooth muscle cell (VSMC) transdifferentiation was absent. The CKD mice were not hypertensive, and cardiac hypertrophy was absent. Freshly excised cardiac tissue respirometry (Oroboros) showed that ADP-stimulated O2 flux was diminished from 52 to 22 pmol/mg (P = 0.022). RNA-Seq of cardiac tissue from CKD mice revealed significantly decreased levels of cardiac mitochondrial oxidative phosphorylation genes. To examine the effect of activin A signaling, some Alport mice were treated with a monoclonal Ab to activin A or an isotype-matched IgG beginning at 75 days of life until euthanasia. Treatment with the activin A antibody (Ab) did not affect cardiac oxidative phosphorylation. However, the activin A antibody was active in the skeleton, disrupting the effect of CKD to stimulate osteoclast number, eroded surfaces, and the stimulation of osteoclast-driven remodeling. The data reported here show that cardiac mitochondrial respiration is impaired in CKD in the absence of conduit arterial disease. This is the first report of the direct effect of CKD on cardiac respiration.NEW & NOTEWORTHY Heart disease is an important morbidity of chronic kidney disease (CKD). Hypertension, vascular stiffness, and vascular calcification all contribute to cardiac pathophysiology. However, cardiac function in CKD devoid of vascular disease has not been studied. Here, in an animal model of human CKD without conduit arterial disease, we analyze cardiac respiration and discover that CKD directly impairs cardiac mitochondrial function by decreasing oxidative phosphorylation. Protection of cardiac oxidative phosphorylation may be a therapeutic target in CKD.
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Affiliation(s)
- Matthew J Williams
- Renal Division, Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Carmen M Halabi
- Renal Division, Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Hiral M Patel
- Renal Division, Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Zachary Joseph
- Renal Division, Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Kyle McCommis
- Geriatrics and Nutritional Science Division, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Carla Weinheimer
- Cardiology Division, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Attila Kovacs
- Cardiology Division, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Florence Lima
- Renal Division, Department of Medicine, University of Kentucky, Lexington, Kentucky, United States
| | - Brian Finck
- Geriatrics and Nutritional Science Division, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Hartmut Malluche
- Renal Division, Department of Medicine, University of Kentucky, Lexington, Kentucky, United States
| | - Keith A Hruska
- Renal Division, Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, United States
- Renal Division, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States
- Department of Cell Biology, Washington University in St. Louis, St. Louis, Missouri, United States
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2
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Evans S, Ma X, Wang X, Chen Y, Zhao C, Weinheimer CJ, Kovacs A, Finck B, Diwan A, Mann DL. Targeting the Autophagy-Lysosome Pathway in a Pathophysiologically Relevant Murine Model of Reversible Heart Failure. JACC Basic Transl Sci 2022; 7:1214-1228. [PMID: 36644282 PMCID: PMC9831862 DOI: 10.1016/j.jacbts.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 11/07/2022]
Abstract
The key biological "drivers" that are responsible for reverse left ventricle (LV) remodeling are not well understood. To gain an understanding of the role of the autophagy-lysosome pathway in reverse LV remodeling, we used a pathophysiologically relevant murine model of reversible heart failure, wherein pressure overload by transaortic constriction superimposed on acute coronary artery (myocardial infarction) ligation leads to a heart failure phenotype that is reversible by hemodynamic unloading. Here we show transaortic constriction + myocardial infarction leads to decreased flux through the autophagy-lysosome pathway with the accumulation of damaged proteins and organelles in cardiac myocytes, whereas hemodynamic unloading is associated with restoration of autophagic flux to normal levels with incomplete removal of damaged proteins and organelles in myocytes and reverse LV remodeling, suggesting that restoration of flux is insufficient to completely restore myocardial proteostasis. Enhancing autophagic flux with adeno-associated virus 9-transcription factor EB resulted in more favorable reverse LV remodeling in mice that had undergone hemodynamic unloading, whereas overexpressing transcription factor EB in mice that have not undergone hemodynamic unloading leads to increased mortality, suggesting that the therapeutic outcomes of enhancing autophagic flux will depend on the conditions in which flux is being studied.
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Key Words
- AAV9, adeno-associated virus 9
- CMV, cytomegalovirus
- CQ, chloroquine
- GFP, green red fluorescent protein
- HF, heart failure
- HF-DB, TAC + MI mice that have undergone debanding
- LFEF, left ventricular ejection fraction
- LV, left ventricle
- MI, myocardial infarction
- RFP, red fluorescent protein
- TAC, transaortic constriction
- TEM, transmission electron microscopic
- TFEB, transcription factor EB
- autophagy
- dsDNA, double stranded DNA
- eGFP, enhanced green fluorescent protein
- mTOR, mammalian target of rapamycin
- reverse left ventricle remodeling
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Affiliation(s)
- Sarah Evans
- Center for Cardiovascular Research, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Xiucui Ma
- Center for Cardiovascular Research, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Xiqiang Wang
- Center for Cardiovascular Research, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Yana Chen
- Division of Geriatrics & Nutritional Science, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Chen Zhao
- Center for Cardiovascular Research, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Carla J. Weinheimer
- Center for Cardiovascular Research, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Attila Kovacs
- Center for Cardiovascular Research, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Brian Finck
- Center for Cardiovascular Research, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA
- Division of Geriatrics & Nutritional Science, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Abhinav Diwan
- Center for Cardiovascular Research, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Douglas L. Mann
- Center for Cardiovascular Research, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA
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Vozenilek AE, Navratil AR, Finck B, Orr AW, Woolard MD. Abstract 608: Macrophage-Associated Lipin-1 Contributes to Atherosclerosis. Arterioscler Thromb Vasc Biol 2017. [DOI: 10.1161/atvb.37.suppl_1.608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective:
Macrophage pro-inflammatory responses induced by oxidized low-density lipoproteins (oxLDL) mediate atherosclerosis progression. However, how oxLDL causes macrophages to become pro-inflammatory is still enigmatic. Macrophage foam cell formation induced by oxLDL requires glycerolipid synthesis. Lipin-1, a key enzyme in the glycerolipid synthesis pathway, contributes to oxLDL-elicited pro-inflammatory responses in a macrophage cell line. The objective of this study was to determine if myeloid-associated lipin-1 contributes to atherogenesis and asses its role in oxLDL-mediated signaling in macrophages
Approach and Results:
We developed mice lacking lipin-1 in myeloid cells and used adeno-associated viral vector 8 expressing the gain-of-function mutation of mouse proprotein convertase subtilisin/kexin type 9 (AAV8-PCSK9) to induce hypercholesterolemia and plaque formation. Mice lacking myeloid-associated lipin-1 had reduced atherosclerotic burden compared to control mice despite similar plasma lipid levels. Stimulation of bone marrow-derived macrophages with oxLDL activated a persistent PKCα/βII-ERK1/2-cJun signaling cascade that contributed to macrophage pro-inflammatory responses. Bone marrow-derived macrophages lacking lipin-1 failed to activate this PKCα/βII-ERK1/2-cJun signaling cascade.
Conclusions:
Our data demonstrates that myeloid-associated lipin-1 is atherogenic, likely through persistent activation of a PKCα/βII-ERK1/2-cJun signaling cascade that contributes to foam cell pro-inflammatory responses. Taken together these results suggest that oxLDL-induced foam cell formation and oxLDL-induced macrophage pro-inflammatory responses are not separate outcomes of oxLDL-stimulation of macrophages, but rather lipid synthesis that contributes to foam cell formation also influences macrophage inflammatory responses.
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Affiliation(s)
- Aimee E Vozenilek
- Louisiana State Univ Health Sciences Cntr-Shreveport, Shreveport, LA
| | | | - Brian Finck
- Washington Univ Sch of Medicine, Saint Louis, MO
| | - A. W Orr
- Louisiana State Univ Health Sciences Cntr-Shreveport, Shreveport, LA
| | - Matthew D Woolard
- Louisiana State Univ Health Sciences Cntr-Shreveport, Shreveport, LA
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O'Dell J, Takeuchi T, Tanaka Y, Louw I, Tiabut T, Kai M, Oribe M, Nakashima S, Finck B. OP0226 Randomized, Double-Blind Study Comparing Chs-0214 with Etanercept in Patients with Active Rheumatoid Arthritis (RA) despite Methotrexate (MTX) Therapy. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1800] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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5
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Finck B. Modulating glycerolipid synthesis and its effects on signaling and metabolism (476.2). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.476.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Brian Finck
- Div of Geriatrics and Nutritional Sci Washington Univ. Sch. of Med.St. LouisMOUnited States
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6
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Gan Z, Burkart-Hartman EM, Han DH, Finck B, Leone TC, Smith EY, Ayala JE, Holloszy J, Kelly DP. The nuclear receptor PPARβ/δ programs muscle glucose metabolism in cooperation with AMPK and MEF2. Genes Dev 2011; 25:2619-30. [PMID: 22135324 DOI: 10.1101/gad.178434.111] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
To identify new gene regulatory pathways controlling skeletal muscle energy metabolism, comparative studies were conducted on muscle-specific transgenic mouse lines expressing the nuclear receptors peroxisome proliferator-activated receptor α (PPARα; muscle creatine kinase [MCK]-PPARα) or PPARβ/δ (MCK-PPARβ/δ). MCK-PPARβ/δ mice are known to have enhanced exercise performance, whereas MCK-PPARα mice perform at low levels. Transcriptional profiling revealed that the lactate dehydrogenase b (Ldhb)/Ldha gene expression ratio is increased in MCK-PPARβ/δ muscle, an isoenzyme shift that diverts pyruvate into the mitochondrion for the final steps of glucose oxidation. PPARβ/δ gain- and loss-of-function studies in skeletal myotubes demonstrated that PPARβ/δ, but not PPARα, interacts with the exercise-inducible kinase AMP-activated protein kinase (AMPK) to synergistically activate Ldhb gene transcription by cooperating with myocyte enhancer factor 2A (MEF2A) in a PPARβ/δ ligand-independent manner. MCK-PPARβ/δ muscle was shown to have high glycogen stores, increased levels of GLUT4, and augmented capacity for mitochondrial pyruvate oxidation, suggesting a broad reprogramming of glucose utilization pathways. Lastly, exercise studies demonstrated that MCK-PPARβ/δ mice persistently oxidized glucose compared with nontransgenic controls, while exhibiting supranormal performance. These results identify a transcriptional regulatory mechanism that increases capacity for muscle glucose utilization in a pattern that resembles the effects of exercise training.
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Affiliation(s)
- Zhenji Gan
- Diabetes and Obesity Research Center, Sanford-Burnham Medical Research Institute, Orlando, Florida 32827, USA.
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7
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Yue P, Chen Z, Nassir F, Bernal-Mizrachi C, Finck B, Azhar S, Abumrad NA. Enhanced hepatic apoA-I secretion and peripheral efflux of cholesterol and phospholipid in CD36 null mice. PLoS One 2010; 5:e9906. [PMID: 20360851 PMCID: PMC2845618 DOI: 10.1371/journal.pone.0009906] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 03/02/2010] [Indexed: 11/19/2022] Open
Abstract
CD36 facilitates oxidized low density lipoprotein uptake and is implicated in development of atherosclerotic lesions. CD36 also binds unmodified high and very low density lipoproteins (HDL, VLDL) but its role in the metabolism of these particles is unclear. Several polymorphisms in the CD36 gene were recently shown to associate with serum HDL cholesterol. To gain insight into potential mechanisms for these associations we examined HDL metabolism in CD36 null (CD36−/−) mice. Feeding CD36−/− mice a high cholesterol diet significantly increased serum HDL, cholesterol and phospholipids, as compared to wild type mice. HDL apolipoproteins apoA-I and apoA-IV were increased and shifted to higher density HDL fractions suggesting altered particle maturation. Clearance of dual-labeled HDL was unchanged in CD36−/− mice and cholesterol uptake from HDL or LDL by isolated CD36−/− hepatocytes was unaltered. However, CD36−/− hepatocytes had higher cholesterol and phospholipid efflux rates. In addition, expression and secretion of apoA-I and apoA-IV were increased reflecting enhanced PXR. Similar to hepatocytes, cholesterol and phospholipid efflux were enhanced in CD36−/− macrophages without changes in protein levels of ABCA1, ABCG1 or SR-B1. However, biotinylation assays showed increased surface ABCA1 localization in CD36−/− cells. In conclusion, CD36 influences reverse cholesterol transport and hepatic ApoA-I production. Both pathways are enhanced in CD36 deficiency, increasing HDL concentrations, which suggests the potential benefit of CD36 inhibition.
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Affiliation(s)
- Pin Yue
- Department of Medicine, Washington University School of Medicine, Center for Human Nutrition, St Louis, Missouri, United States of America.
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8
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Marionneau C, Aimond F, Brunet S, Niwa N, Finck B, Kelly DP, Nerbonne JM. PPARalpha-mediated remodeling of repolarizing voltage-gated K+ (Kv) channels in a mouse model of metabolic cardiomyopathy. J Mol Cell Cardiol 2008; 44:1002-1015. [PMID: 18482733 PMCID: PMC2577840 DOI: 10.1016/j.yjmcc.2008.03.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2007] [Revised: 03/15/2008] [Accepted: 03/27/2008] [Indexed: 02/06/2023]
Abstract
Diabetes is associated with increased risk of diastolic dysfunction, heart failure, QT prolongation and rhythm disturbances independent of age, hypertension or coronary artery disease. Although these observations suggest electrical remodeling in the heart with diabetes, the relationship between the metabolic and the functional derangements is poorly understood. Exploiting a mouse model (MHC-PPARalpha) with cardiac-specific overexpression of the peroxisome proliferator-activated receptor alpha (PPARalpha), a key driver of diabetes-related lipid metabolic dysregulation, the experiments here were aimed at examining directly the link(s) between alterations in cardiac fatty acid metabolism and the functioning of repolarizing, voltage-gated K(+) (Kv) channels. Electrophysiological experiments on left (LV) and right (RV) ventricular myocytes isolated from young (5-6 week) MHC-PPARalpha mice revealed marked K(+) current remodeling: I(to,f) densities are significantly (P<0.01) lower, whereas I(ss) densities are significantly (P<0.001) higher in MHC-PPARalpha, compared with age-matched wild type (WT), LV and RV myocytes. Consistent with the observed reductions in I(to,f) density, expression of the KCND2 (Kv4.2) transcript is significantly (P<0.001) lower in MHC-PPARalpha, compared with WT, ventricles. Western blot analyses revealed that expression of the Kv accessory protein, KChIP2, is also reduced in MHC-PPARalpha ventricles in parallel with the decrease in Kv4.2. Although the properties of the endogenous and the "augmented" I(ss) suggest a role(s) for two pore domain K(+) channel (K2P) pore-forming subunits, the expression levels of KCNK2 (TREK1), KCNK3 (TASK1) and KCNK5 (TASK2) in MHC-PPARalpha and WT ventricles are not significantly different. The molecular mechanisms underlying I(to,f) and I(ss) remodeling in MHC-PPARalpha ventricular myocytes, therefore, are distinct.
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Affiliation(s)
- Céline Marionneau
- Department of Molecular Biology and Pharmacology, Washington University Medical School, St. Louis, MO 63110, USA
| | - Franck Aimond
- Department of Molecular Biology and Pharmacology, Washington University Medical School, St. Louis, MO 63110, USA
| | - Sylvain Brunet
- Department of Molecular Biology and Pharmacology, Washington University Medical School, St. Louis, MO 63110, USA
| | - Noriko Niwa
- Department of Molecular Biology and Pharmacology, Washington University Medical School, St. Louis, MO 63110, USA
| | - Brian Finck
- Department of Internal Medicine, Washington University Medical School, St. Louis, MO 63110, USA
| | - Daniel P Kelly
- Department of Molecular Biology and Pharmacology, Washington University Medical School, St. Louis, MO 63110, USA; Department of Internal Medicine, Washington University Medical School, St. Louis, MO 63110, USA
| | - Jeanne M Nerbonne
- Department of Molecular Biology and Pharmacology, Washington University Medical School, St. Louis, MO 63110, USA.
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9
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Lambert C, Wright N, Finck B, Villareal D. Exercise but not Diet Induced Weight Loss Decreases Skeletal Muscle Inflammatory Gene Expression in Frail Obese Elderly. FASEB J 2008. [DOI: 10.1096/fasebj.22.1_supplement.1095.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Charles Lambert
- Internal MedicineWashington University School of MedicineSt. LouisMO
| | - Nicole Wright
- Internal MedicineWashington University School of MedicineSt. LouisMO
| | - Brian Finck
- Internal MedicineWashington University School of MedicineSt. LouisMO
| | - Dennis Villareal
- Internal MedicineWashington University School of MedicineSt. LouisMO
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10
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Coughlin CC, McCrea J, Eagon JC, Halpin V, Finck B, Klein S. Effect of marked weight loss on adiponectin plasma concentration and adipose tissue expression in extremely obese subjects. FASEB J 2006. [DOI: 10.1096/fasebj.20.5.lb96-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Carrie Christine Coughlin
- Center for Human NutritionWashington University School of Medicine660 S. Euclid, 8031St. LouisMO63110
| | - Jennifer McCrea
- Center for Human NutritionWashington University School of Medicine660 S. Euclid, 8031St. LouisMO63110
| | - J. Christopher Eagon
- Center for Human NutritionWashington University School of Medicine660 S. Euclid, 8031St. LouisMO63110
| | - Valerie Halpin
- Center for Human NutritionWashington University School of Medicine660 S. Euclid, 8031St. LouisMO63110
| | - Brian Finck
- Center for Human NutritionWashington University School of Medicine660 S. Euclid, 8031St. LouisMO63110
| | - Samuel Klein
- Center for Human NutritionWashington University School of Medicine660 S. Euclid, 8031St. LouisMO63110
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11
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Ramakrishnan V, Bhaskar V, Law DA, Wong MHL, Green J, Tso J, Jeffry U, Finck B, Murray R. M200, an integrin α5β1 antibody, promotes apoptosis in proliferating endothelial cells. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- V. Ramakrishnan
- Protein Design Labs, Inc., Fremont, CA; Chiron Corporation, Emeryville, CA
| | - V. Bhaskar
- Protein Design Labs, Inc., Fremont, CA; Chiron Corporation, Emeryville, CA
| | - D. A. Law
- Protein Design Labs, Inc., Fremont, CA; Chiron Corporation, Emeryville, CA
| | - M. H.-L. Wong
- Protein Design Labs, Inc., Fremont, CA; Chiron Corporation, Emeryville, CA
| | - J. Green
- Protein Design Labs, Inc., Fremont, CA; Chiron Corporation, Emeryville, CA
| | - J. Tso
- Protein Design Labs, Inc., Fremont, CA; Chiron Corporation, Emeryville, CA
| | - U. Jeffry
- Protein Design Labs, Inc., Fremont, CA; Chiron Corporation, Emeryville, CA
| | - B. Finck
- Protein Design Labs, Inc., Fremont, CA; Chiron Corporation, Emeryville, CA
| | - R. Murray
- Protein Design Labs, Inc., Fremont, CA; Chiron Corporation, Emeryville, CA
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12
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Aimond F, Brunet S, Finck B, Kelly D, Nerbonne J. 03 Alterations in fatty acid utilization modulate voltage-dependent K+ currents in mouse ventricular myocytes. J Mol Cell Cardiol 2002. [DOI: 10.1016/s0022-2828(02)90133-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
BACKGROUND Etanercept, a tumour-necrosis-factor inhibitor, has shown efficacy in the treatment of rheumatoid arthritis. Psoriatic arthritis and psoriasis are disease states in which tumour necrosis factor, a proinflammatory cytokine, is present in increased concentrations in joints and in the skin. Therefore, psoriatic arthritis and psoriasis may be appropriate therapeutic targets for etanercept. METHODS This randomised, double-blind, placebo-controlled, 12 week study assessed the efficacy and safety of etanercept (25 mg twice-weekly subcutaneous injections) or placebo in 60 patients with psoriatic arthritis and psoriasis. Psoriatic arthritis endpoints included the proportion of patients who met the Psoriatic Arthritis Response Criteria (PsARC) and who met the American College of Rheumatology preliminary criteria for improvement (ACR20). Psoriasis endpoints included improvement in the psoriasis area and severity index (PASI) and improvement in prospectively-identified individual target lesions. FINDINGS In this 12 week study, 26 (87%) of etanercept-treated patients met the PsARC, compared with seven (23%) of placebo-controlled patients. The ARC20 was achieved by 22 (73%) of etanercept-treated patients compared with four (13%) of placebo-treated patients. Of the 19 patients in each treatment group who could be assessed for psoriasis (> or = 3% body surface area), five (26%) of etanercept-treated patients achieved a 75% improvement in the PASI, compared with none of the placebo-treated patients (p=0.015). The median PASI improvement was 46% in etanercept-treated patients versus 9% in placebo-treated patients; similarly, median target lesion improvements were 50% and 0, respectively. Etanercept was well tolerated. INTERPRETATION Etanercept offers patients with psoriatic arthritis and psoriasis a new therapeutic option for control of their disease.
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Affiliation(s)
- P J Mease
- Minor and James Medical, Seattle, WA 98104, USA.
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Bernaudin F, Verlhac S, Fréard F, Roudot-Thoraval F, Benkerrou M, Thuret I, Mardini R, Vannier JP, Ploix E, Romero M, Cassé-Perrot C, Helly M, Gillard E, Sebag G, Kchouk H, Pracros JP, Finck B, Dacher JN, Ickowicz V, Raybaud C, Poncet M, Lesprit E, Reinert PH, Brugières P. Multicenter prospective study of children with sickle cell disease: radiographic and psychometric correlation. J Child Neurol 2000; 15:333-43. [PMID: 10830200 DOI: 10.1177/088307380001500510] [Citation(s) in RCA: 184] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
After obtaining familial informed consent, between January 1996 and July 1997, 173 children (5 to 15 years old) with sickle cell disease were enrolled in a prospective multicenter study using blood screening, transcranial Doppler ultrasonography (n = 143), cerebral magnetic resonance imaging (n = 144), and neuropsychologic performance evaluation (n = 156) (Wechsler Intelligence tests WISC-III, WIPPSI-R), which were also performed in 76 sibling controls (5 to 15 years old). Among the 173 patients with sickle cell disease (155 homozygous for hemoglobin SS, 8 sickle cell beta0 thalassemia, 3 sickle cell beta+ thalassemia, 7 sickle cell hemoglobin C disease SC), 12 (6.9%) had a history of overt stroke, and the incidence of abnormal transcranial Doppler ultrasonography (defined as mean middle cerebral artery velocity > 200 cm/sec or absent) was 8.4% in the overall study population and 9.6% in patients with homozygous sickle cell anemia The silent stroke rate was 15%. Significantly impaired cognitive functioning was observed in sickle cell disease patients with a history of stroke (Performance IQ and Full Scale IQ), but also in patients with silent strokes (Similarities, Vocabulary, and Verbal Comprehension). However, infarcts on magnetic resonance imaging were not the only factors of cognitive deficit: Verbal IQ, Performance IQ, and Full Scale IQ were strongly impaired in patients with severe chronic anemia (hematocrit < or = 20%) and in those with thrombocytosis (platelets > 500 x 10(9)/L). Multivariate logistic regression analysis showed that abnormal magnetic resonance imaging (odds ratio [OR] = 2.76) (P = .047), hematocrit < or =20% (OR = 5.85) (P = .005), and platelets > 500 x 10(9)/L (OR = 3.99) (P = .004) were independent factors of cognitive deficiency (Full Scale IQ < 75) in sickle cell disease patients. The unfavorable effect of low hematocrit has already been suggested, but this is the first report concerning an effect of thrombocytosis and showing that silent stroke alone is not a factor of cognitive deficit when not associated with low hematocrit or thrombocytosis. The effect of hydroxyurea, which is known to increase hematocrit and decrease platelet count, on cognitive functioning of sickle cell patients should be evaluated prospectively.
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Affiliation(s)
- F Bernaudin
- Department of Pediatrics, Hôpital Intercommunal de Créteil, France.
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Revel D, Finck B. Magnetic resonance imaging of congenital heart disease. Curr Opin Radiol 1990; 2:581-5. [PMID: 2204397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- D Revel
- Hôpital Cardiologique et Pneumologique, Lyon, France
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