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Sharp TE, Scarborough AL, Li Z, Polhemus DJ, Hidalgo HA, Schumacher JD, Matsuura TR, Jenkins JS, Kelly DP, Goodchild TT, Lefer DJ. Novel Göttingen Miniswine Model of Heart Failure With Preserved Ejection Fraction Integrating Multiple Comorbidities. JACC Basic Transl Sci 2021; 6:154-170. [PMID: 33665515 PMCID: PMC7907541 DOI: 10.1016/j.jacbts.2020.11.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 10/14/2020] [Accepted: 11/19/2020] [Indexed: 01/07/2023]
Abstract
A lack of preclinical large animal models of heart failure with preserved ejection fraction (HFpEF) that recapitulate this comorbid-laden syndrome has led to the inability to tease out mechanistic insights and to test novel therapeutic strategies. This study developed a large animal model that integrated multiple comorbid determinants of HFpEF in a miniswine breed that exhibited sensitivity to obesity, metabolic syndrome, and vascular disease with overt clinical signs of heart failure. The combination of a Western diet and 11-deoxycorticosterone acetate salt-induced hypertension in the Göttingen miniswine led to the development of a novel large animal model of HFpEF that exhibited multiorgan involvement and a full spectrum of comorbidities associated with human HFpEF.
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Key Words
- DBP, diastolic blood pressure
- DOCA, 11-deoxycorticosterone acetate
- EC50, half-maximal effective concentration
- EF, ejection fraction
- HDL, high-density lipoprotein
- HFpEF, heart failure with preserved ejection fraction
- HFrEF, heart failure with reduced ejection fraction
- IVGTT, intravenous glucose tolerance test
- LDL, low-density lipoprotein
- LV, left ventricle
- PCWP, pulmonary capillary wedge pressure
- SBP, systolic blood pressure
- TC, total cholesterol
- WD, Western diet
- animal models of human disease
- heart failure with preserved ejection fraction
- hypertension
- metabolic syndrome
- obesity
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Affiliation(s)
- Thomas E Sharp
- Cardiovascular Center of Excellence, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana, USA
| | - Amy L Scarborough
- Cardiovascular Center of Excellence, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana, USA
| | - Zhen Li
- Cardiovascular Center of Excellence, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana, USA
| | - David J Polhemus
- Cardiovascular Center of Excellence, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana, USA
| | - Hunter A Hidalgo
- Cardiovascular Center of Excellence, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana, USA.,Department of Pharmacology and Experimental Therapeutics, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana, USA
| | - Jeffery D Schumacher
- Department of Animal Care, Louisiana State University Health Science Center, New Orleans, Louisiana, USA
| | - Timothy R Matsuura
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - J Stephen Jenkins
- Department of Cardiology, Heart and Vascular Institute, Ochsner Medical Center, New Orleans, Louisiana, USA
| | - Daniel P Kelly
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Traci T Goodchild
- Cardiovascular Center of Excellence, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana, USA.,Department of Pharmacology and Experimental Therapeutics, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana, USA
| | - David J Lefer
- Cardiovascular Center of Excellence, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana, USA.,Department of Pharmacology and Experimental Therapeutics, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana, USA
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Schumacher JD, Kong B, Wu J, Rizzolo D, Armstrong LE, Chow MD, Goedken M, Lee YH, Guo GL. Direct and Indirect Effects of Fibroblast Growth Factor (FGF) 15 and FGF19 on Liver Fibrosis Development. Hepatology 2020; 71:670-685. [PMID: 31206730 PMCID: PMC6918008 DOI: 10.1002/hep.30810] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 05/28/2019] [Indexed: 12/18/2022]
Abstract
Farnesoid X receptor (FXR) induces fibroblast growth factor 15 (FGF15; human ortholog FGF19) in the gut to potently inhibit bile acid (BA) synthesis in the liver. FXR activation in hepatic stellate cells (HSCs) reduces liver fibrosis (LF). Fgf15-/- mice develop attenuated LF, but the underlying mechanisms for this protection are unclear. We hypothesized that FGF15/19 functions as a profibrotic mediator or mitogen to HSCs and increased BAs in Fgf15-/- mice leads to enhanced FXR activation in HSCs, subsequently reducing fibrogenesis. In this study, complimentary in vivo and in vitro approaches were used: (1) CCl4 -induced LF model in wild type (WT), Fgf15-/- , and Fgf15 transgenic (TG) mice with BA levels modulated by feeding cholestyramine- or cholic acid-containing diets; (2) analysis of primary HSCs isolated from WT and Fgf15-/- mice; and (3) treatment of a human HSC line, LX-2, with FXR activators and/or recombinant FGF19 protein. The results showed that Fgf15-/- mice had lower basal collagen expression, which was increased by BA sequestration. CCl4 induced fibrosis with similar severity in all genotypes; however, cholestyramine increased fibrosis severity only in Fgf15-/- mice. HSCs from Fgf15-/- mice showed increased FXR activity and reduced expression of profibrotic mediators. In LX-2 cells, FXR activation increased peroxisome proliferator-activated receptor gamma activity and reduced proliferation. FGF19 activated both signal transducer and activator of transcription 3 and c-Jun N-terminal kinase pathways and reduced nuclear factor kappa-light-chain-enhancer of activated B cells signaling without increasing fibrogenic gene expression or cell proliferation. Conclusion: FGF15/19 does not act as a direct profibrotic mediator or mitogen to HSCs in our models, and the protection against fibrosis by FGF15 deficiency may be mediated through increased BA activation of FXR in HSCs.
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Affiliation(s)
- JD Schumacher
- Department of Pharmacology and Toxicology, Rutgers University, Piscataway, NJ
| | - B Kong
- Department of Pharmacology and Toxicology, Rutgers University, Piscataway, NJ
| | - J Wu
- Department of Pharmacology and Toxicology, Rutgers University, Piscataway, NJ
| | - D Rizzolo
- Department of Pharmacology and Toxicology, Rutgers University, Piscataway, NJ
| | - LE Armstrong
- Department of Pharmacology and Toxicology, Rutgers University, Piscataway, NJ
| | - MD Chow
- Department of Surgery, Robert Wood Johnson University Hospital, New Brunswick, NJ
| | - M Goedken
- Research pathology services, Rutgers University, Piscataway, NJ
| | - YH Lee
- Department of Surgery, Robert Wood Johnson University Hospital, New Brunswick, NJ
| | - GL Guo
- Department of Pharmacology and Toxicology, Rutgers University, Piscataway, NJ.,Environmental and Occupational Health Institute, Rutgers University, Piscataway, NJ.,VA New Jersey Health Care System, East Orange, NJ,Corresponding author: Grace L. Guo, MBBS, PhD, 170 Frelinghuysen Road, Piscataway, NJ, 08854; ; phone - 848-445-8186
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Schumacher JD, Kong B, Pan Y, Zhan L, Sun R, Aa J, Rizzolo D, Richardson JR, Chen A, Goedken M, Aleksunes LM, Laskin DL, Guo GL. The effect of fibroblast growth factor 15 deficiency on the development of high fat diet induced non-alcoholic steatohepatitis. Toxicol Appl Pharmacol 2017; 330:1-8. [PMID: 28673684 DOI: 10.1016/j.taap.2017.06.023] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 06/16/2017] [Accepted: 06/29/2017] [Indexed: 12/28/2022]
Abstract
Non-alcoholic steatohepatitis (NASH) is a form of non-alcoholic fatty liver disease (NAFLD) characterized by steatosis, inflammation, and fibrosis often associated with metabolic syndrome. Fibroblast growth factor 15 (FGF15), an endocrine factor mainly produced in the distal part of small intestine, has emerged to be a critical factor in regulating bile acid homeostasis, energy metabolism, and liver regeneration. We hypothesized that FGF15 alters the development of each of the listed features of NASH. To test this hypothesis, four-week old male Fgf15-/- and their corresponding wild-type (WT) mice were fed either a high fat diet (HFD) or a control chow diet for six months. The results confirmed that HFD feeding for six months in WT mice recapitulated human NASH phenotype, including macrovesicular steatosis, inflammation, and fibrosis. Whereas FGF15 deficiency had no effect on the severity of liver steatosis or inflammation, it was associated with decreased liver fibrosis. Furthermore, FGF15 deficiency resulted in abnormal bile acid homeostasis, increased insulin resistance, increased HFD-induced serum triglycerides, decreased inductions of hepatic cholesterol content by HFD, and altered gene expression of lipid metabolic enzymes. These data suggest that FGF15 improves lipid homeostasis and reduces bile acid synthesis, but promotes fibrosis during the development of NASH.
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Affiliation(s)
- J D Schumacher
- Department of Pharmacology and Toxicology, School of Pharmacy, EOHSI, Rutgers University, Piscataway, NJ 08854, United States
| | - B Kong
- Department of Pharmacology and Toxicology, School of Pharmacy, EOHSI, Rutgers University, Piscataway, NJ 08854, United States
| | - Y Pan
- Key Laboratory of Drug Metabolism and Pharmacokinetics, China Pharmaceutical University, Nanjing 210009, China
| | - L Zhan
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, United States
| | - R Sun
- Key Laboratory of Drug Metabolism and Pharmacokinetics, China Pharmaceutical University, Nanjing 210009, China
| | - J Aa
- Key Laboratory of Drug Metabolism and Pharmacokinetics, China Pharmaceutical University, Nanjing 210009, China
| | - D Rizzolo
- Department of Pharmacology and Toxicology, School of Pharmacy, EOHSI, Rutgers University, Piscataway, NJ 08854, United States
| | - J R Richardson
- Department of Pharmacology and Toxicology, School of Pharmacy, EOHSI, Rutgers University, Piscataway, NJ 08854, United States
| | - A Chen
- Department of Pathology, St. Louis University, St. Louis, MO 63104, United States
| | - M Goedken
- Department of Pharmacology and Toxicology, School of Pharmacy, EOHSI, Rutgers University, Piscataway, NJ 08854, United States
| | - L M Aleksunes
- Department of Pharmacology and Toxicology, School of Pharmacy, EOHSI, Rutgers University, Piscataway, NJ 08854, United States
| | - D L Laskin
- Department of Pharmacology and Toxicology, School of Pharmacy, EOHSI, Rutgers University, Piscataway, NJ 08854, United States
| | - G L Guo
- Department of Pharmacology and Toxicology, School of Pharmacy, EOHSI, Rutgers University, Piscataway, NJ 08854, United States.
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Abstract
This study includes 80 patients (38 children and 42 adults) who contracted aseptic meningitis in the summer of 1996 in Fribourg, Switzerland. Virological studies revealed an enteroviral infection in 65 out of 70 (93%) investigated patients. In 47 out of the 53 cases (89%) where a precise virus could be identified, the causative agent was an Echovirus 30. More than 50 patients lived in an area within a 5-km radius. The patients presented with the classic symptoms and signs of aseptic meningitis. In contrast, polymorphonuclear leukocytes predominated in the cerebrospinal fluid in the first 24 h and 32% of the cases had a left shift in their peripheral blood smear. The patients' age did not influence white blood cell count, the proportion of polymorphonuclear leukocytes or protein concentration in the cerebrospinal fluid. Thirty-three patients (41%) received antibiotic treatment, and 38 patients (48%) left the hospital within 24 h. Only 2 neuroradiological procedures and 1 electroencephalographic recording were performed. The outcome was favourable in all patients.
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Affiliation(s)
- J D Schumacher
- Department of Internal Medicine, Hôpital Cantonal, Fribourg, Switzerland
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Milch RA, Schumacher JD. The future of hospice. West J Med 1999; 171:224. [PMID: 10578670 PMCID: PMC1305849] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- R A Milch
- Center for Hospice and Palliative Care, Buffalo, NY, USA.
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Abstract
The present work describes investigations on the bacterial degradation of the alicyclic molecule cyclododecane. It represents a structure where the initial degradative steps have to be similar to a "subterminal" attack as there is no "terminal" part of the molecule. We were able to show that the gram-positive bacterium Rhodococcus ruber CD4 DSM 44394 oxidizes cyclododecane to the corresponding alcohol and ketone, the latter being subject to ring fission by a Baeyer-Villiger oxygenase. This key enzyme is an NADPH- and O2-dependent flavoprotein with a substrate specificity for bigger rings. The further metabolism of the resulting lactone gives rise to an omega-hydroxyalkanoic acid that is susceptible to common beta-oxidation. Due to its alicyclic character and its ring size, cyclododecane is comparable to aliphatic bridge components that are an important element in the coal texture. They contribute to the three-dimensional coal structure and thus could serve as a valuable target for the oxidative abilities of R. ruber CD4 to reduce the molecular mass of coal.
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Affiliation(s)
- J D Schumacher
- Institut für Mikrobiologie und Biotechnologie, Universität Bonn, Germany
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Gorgievski-Hrisoho M, Schumacher JD, Vilimonovic N, Germann D, Matter L. Detection by PCR of enteroviruses in cerebrospinal fluid during a summer outbreak of aseptic meningitis in Switzerland. J Clin Microbiol 1998; 36:2408-12. [PMID: 9705364 PMCID: PMC105134 DOI: 10.1128/jcm.36.9.2408-2412.1998] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Enteroviruses (EV) are among the most common causes of aseptic meningitis. Standard diagnostic techniques are often too slow and lack sensitivity to be of clinical relevance. EV RNA can be detected within 5 h by a commercially available reverse transcription-PCR (RT-PCR) test kit. Cerebrospinal fluid (CSF) samples from 68 patients presenting with aseptic meningitis during a summer outbreak in Switzerland were examined in parallel with cell culture and commercial RT-PCR. RT-PCR was positive in all 16 CSF specimens positive by cell culture (100%). In addition, 42 of 52 (80%) CSF samples negative by cell culture were PCR positive. In 26 of these 42 (62%) patients, viral culture from other sites (throat swab or stool) was also positive. The CSF virus culture took 3 to 7 days to become positive. Echovirus 30 was the type most often isolated in this outbreak. The sensitivity of CSF RT-PCR based on clinical diagnosis during this aseptic meningitis outbreak in patients with negative bacterial culture results was 85%, i.e., considerably higher than the sensitivity of CSF virus culture (24%). We conclude that this commercial RT-PCR assay allows a positive diagnosis with minimal delay and may thus influence clinical decisions.
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Schumacher JD, Schmid L, Waldburger M. [Chondrocalcinosis and Bartter syndrome]. Praxis (Bern 1994) 1996; 85:517-519. [PMID: 8657995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
A patient presenting with acute left-knee arthritis was diagnosed as having articular chondrocalcinosis. Routine laboratory tests motivated by a history of muscular cramps and weakness revealed hypokalemia and hypomagnesemia. Further investigations showed Bartter's syndrome. The characteristics of Bartter's syndrome and chondrocalcinosis and the relationship between the two diseases are developed.
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Affiliation(s)
- J D Schumacher
- Service de rhumatologie, médecine physique et réhabilitation, Hôpital cantonal, Fribourg
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Balagué F, Anchisi S, Schumacher JD, Hoogewoud HM, Waldburger M. Uncommon origin for the iliopsoas sign. J Rheumatol Suppl 1993; 20:510-1. [PMID: 8478860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The term "iliopsoas sign" has different meanings in the medical literature. Among musculoskeletal disorders, iliopsoas bursitis is probably the most common cause of this clinical sign. Here we report an unexpected vascular pathology in a young man. The only clinical manifestation on examination was an iliopsoas sign.
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Affiliation(s)
- F Balagué
- Service de Rhumatologie, Hôpital Cantonal, Fribourg, Switzerland
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