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Aaseth JO, Alehagen U, Opstad TB, Alexander J. Vitamin K and Calcium Chelation in Vascular Health. Biomedicines 2023; 11:3154. [PMID: 38137375 PMCID: PMC10740993 DOI: 10.3390/biomedicines11123154] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/17/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023] Open
Abstract
The observation that the extent of artery calcification correlates with the degree of atherosclerosis was the background for the alternative treatment of cardiovascular disease with chelator ethylenediamine tetraacetate (EDTA). Recent studies have indicated that such chelation treatment has only marginal impact on the course of vascular disease. In contrast, endogenous calcium chelation with removal of calcium from the cardiovascular system paralleled by improved bone mineralization exerted, i.e., by matrix Gla protein (MGP) and osteocalcin, appears to significantly delay the development of cardiovascular diseases. After post-translational vitamin-K-dependent carboxylation of glutamic acid residues, MGP and other vitamin-K-dependent proteins (VKDPs) can chelate calcium through vicinal carboxyl groups. Dietary vitamin K is mainly provided in the form of phylloquinone from green leafy vegetables and as menaquinones from fermented foods. Here, we provide a review of clinical studies, addressing the role of vitamin K in cardiovascular diseases, and an overview of vitamin K kinetics and biological actions, including vitamin-K-dependent carboxylation and calcium chelation, as compared with the action of the exogenous (therapeutic) chelator EDTA. Consumption of vitamin-K-rich foods and/or use of vitamin K supplements appear to be a better preventive strategy than EDTA chelation for maintaining vascular health.
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Affiliation(s)
- Jan O. Aaseth
- Research Department, Innlandet Hospital Trust, P.O. Box 104, N-2381 Brumunddal, Norway
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, P.O. Box 400, N-2418 Elverum, Norway
| | - Urban Alehagen
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, SE-581 85 Linköping, Sweden;
| | - Trine Baur Opstad
- Oslo Centre for Clinical Heart Research Laboratory, Department of Cardiology, Oslo University Hospital Ullevål, P.O. Box 4950, Nydalen, N-0424 Oslo, Norway;
- Faculty of Medicine, University of Oslo, N-0370 Oslo, Norway
| | - Jan Alexander
- Norwegian Institute of Public Health, P.O. Box 222, N-0213 Oslo, Norway;
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Opstad TB, Papotti B, Åkra S, Hansen CH, Braathen B, Tønnessen T, Solheim S, Seljeflot I. Sirtuin1, not NAMPT, possesses anti-inflammatory effects in epicardial, pericardial and subcutaneous adipose tissue in patients with CHD. J Transl Med 2023; 21:644. [PMID: 37730614 PMCID: PMC10512577 DOI: 10.1186/s12967-023-04518-4] [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: 07/21/2023] [Accepted: 09/11/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Inflammation in cardiac adipose tissue (AT) is associated with atherosclerosis. We investigated whether the epicardial-, pericardial and pre-sternal subcutaneous AT (EAT, PAT and SAT) expression of Sirtuin1 (SIRT1) and nicotinamide phosphoribosyl transferase (NAMPT) are involved in the inflammatory process in coronary heart disease (CHD), and potentially associated to nod-like receptor family pyrin domain containing 3 (NLRP3) inflammasome-related markers, macrophage polarization markers, cell markers and the cardiometabolic profile. METHODS In this cohort study performed between 2016 and 2018, EAT, PAT and SAT biopsies were retrieved from 52 CHD patients (77% men, median age 67) undergoing open-chest coronary artery bypass grafting (CABG), and 22 patients (50% men, median age 69) undergoing aortic valve replacement serving as controls. AT samples were snap-frozen at - 80 °C until RNA extraction and AT expression of actual markers, relatively quantified by PCR. Circulating SIRT1 and NAMPT were measured with Enzyme-linked immunosorbent assays (ELISAs). Non-parametric statistical tests were mainly used, including Friedman's test coupled to Wilcoxon signed-rank test and Spearman Correlation. RESULTS SIRT1 and NAMPT levels were similar in CHD and controls. In CHD, SIRT1 and NAMPT were inter-correlated in all AT compartments (r = 0.37-0.56, p < 0.01, all), and differently expressed between compartments, with the highest expression in SAT, significantly different from EAT (p < 0.01, both). Circulating SIRT1 and NAMPT levels were inversely associated (r = - 0.32, p = 0.024). In EAT and SAT, SIRT1 expression was inversely associated with IL-18 (r = - 0.43 and r = - 0.38, p < 0.01, both), whereas NAMPT expression was positively associated with the NLRP3 inflammasome-related markers in all compartments (r = 0.37-0.55, p < 0.01, all). While SIRT1 and NAMPT correlated to nitric oxide synthase 2 (NOS2), especially in SAT (r = 0.50-0.52, p ≤ 0.01, both), SIRT1 expression was related to endothelial cells, and NAMPT to macrophages. SIRT1 levels were correlated to weight and waist (r = 0.32 and r = 0.38, p < 0.03, both) and inversely to triglycerides and glycated haemoglobin (HbA1c) (r = - 0.33-- 0.37, p < 0.03, all), the latter positively correlated to NAMPT concentration (r = 0.39, p = 0.010). CONCLUSION The study indicates that targeting SIRT1, with its anti-inflammatory properties, may be a novel anti-inflammatory strategy in preventing atherosclerosis and CHD progression. NAMPT may be an early player in AT inflammation, mediating/reflecting a pro-inflammatory state. TRIAL REGISTRATION Registration: Clinicaltrials.gov ID: NCT02760914, registered the 5th of February 2016, http://clinicaltrials.gov/NCT02760914.
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Affiliation(s)
- Trine Baur Opstad
- Center for Clinical Heart Research, Department of Cardiology, Oslo University, Hospital Ullevål, Pb 4954 Nydalen, 240, Oslo, Norway.
- Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Bianca Papotti
- Department of Food and Drug, University of Parma, Parma, Italy
| | - Sissel Åkra
- Center for Clinical Heart Research, Department of Cardiology, Oslo University, Hospital Ullevål, Pb 4954 Nydalen, 240, Oslo, Norway
| | - Charlotte Holst Hansen
- Center for Clinical Heart Research, Department of Cardiology, Oslo University, Hospital Ullevål, Pb 4954 Nydalen, 240, Oslo, Norway
| | - Bjørn Braathen
- Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | - Theis Tønnessen
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | - Svein Solheim
- Center for Clinical Heart Research, Department of Cardiology, Oslo University, Hospital Ullevål, Pb 4954 Nydalen, 240, Oslo, Norway
| | - Ingebjørg Seljeflot
- Center for Clinical Heart Research, Department of Cardiology, Oslo University, Hospital Ullevål, Pb 4954 Nydalen, 240, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
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Opstad TB, Alexander J, Aaseth J, Larsson A, Seljeflot I, Alehagen U. Increased SIRT1 Concentration Following Four Years of Selenium and Q 10 Intervention Associated with Reduced Cardiovascular Mortality at 10-Year Follow-Up-Sub-Study of a Previous Prospective Double-Blind Placebo-Controlled Randomized Clinical Trial. Antioxidants (Basel) 2023; 12:antiox12030759. [PMID: 36979007 PMCID: PMC10045001 DOI: 10.3390/antiox12030759] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/02/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Background: Selenium and coenzyme Q10 (SeQ10) possess antioxidant and anti-inflammatory properties, potentially mediated via Sirtuin1 (SIRT1). We aimed to investigate the influence of a SeQ10 intervention on SIRT1 concentration, with potential interactions with microRNAs. Methods: In this sub-study of a prospective double-blind placebo-controlled clinical trial, healthy subjects (mean age 76 years) were randomized to receive an active treatment (n = 165, combined 200 µg/day of Se and 200 mg/day of Q10) or a placebo (n = 161). SIRT1 concentration and microRNAs were measured with ELISA and PCR, respectively. Results: After four years, SIRT1 concentration was increased in the active treatment group, with mean (SD) ng/mL of 469 (436) vs. 252 (162), p < 0.001, and decreased in the placebo group, 190 (186) vs. 269 (172), p = 0.002, and the differences between the groups were significant (p = 0.006, adjusted). Those who suffered CV death during a 10-year follow-up (n = 25 and n = 52 in the active treatment and placebo groups, respectively) had significantly lower baseline SIRT1 concentrations compared to the survivors (p < 0.001). MiR-130a-3p was significantly downregulated during the intervention and correlated inversely with SIRT1 at baseline (r = -0.466, p = 0.007). Conclusion: The increased SIRT1 concentration after the SeQ10 intervention associated with reduced CV mortality, partly mediated via miR-1303a-3p, suggests that SIRT1 is an additional mediator of the intervention, preventing vascular ageing.
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Affiliation(s)
- Trine Baur Opstad
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, P.O. Box 4950, Nydalen, N-0424 Oslo, Norway
- Faculty of Medicine, University of Oslo, N-0370 Oslo, Norway
| | - Jan Alexander
- Norwegian Institute of Public Health, P.O. Box 222, Skøyen, N-0213 Oslo, Norway
| | - Jan Aaseth
- Department of Research, Innlandet Hospital Trust, P.O. Box 104, N-2381 Brumunddal, Norway
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, N-2624 Lillehammer, Norway
| | - Anders Larsson
- Department of Medical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden
| | - Ingebjørg Seljeflot
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, P.O. Box 4950, Nydalen, N-0424 Oslo, Norway
- Faculty of Medicine, University of Oslo, N-0370 Oslo, Norway
| | - Urban Alehagen
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, SE-581 85 Linköping, Sweden
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Papotti B, Opstad TB, Åkra S, Tønnessen T, Braathen B, Hansen CH, Arnesen H, Solheim S, Seljeflot I, Ronda N. Macrophage polarization markers in subcutaneous, pericardial, and epicardial adipose tissue are altered in patients with coronary heart disease. Front Cardiovasc Med 2023; 10:1055069. [PMID: 36937936 PMCID: PMC10017535 DOI: 10.3389/fcvm.2023.1055069] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Background Epicardial and pericardial adipose tissue (EAT and PAT) surround and protect the heart, with EAT directly sharing the microcirculation with the myocardium, possibly presenting a distinct macrophage phenotype that might affect the inflammatory environment in coronary heart disease (CHD). This study aims to investigate the expression of genes in different AT compartments driving the polarization of AT macrophages toward an anti-inflammatory (L-Galectin 9; CD206) or pro-inflammatory (NOS2) phenotype. Methods EAT, PAT, and subcutaneous (SAT) biopsies were collected from 52 CHD patients undergoing coronary artery bypass grafting, and from 22 CTRLs undergoing aortic valve replacement. L-Galectin9 (L-Gal9), CD206, and NOS2 AT gene expression and circulating levels were analyzed through RT-PCR and ELISA, respectively. Results L-Gal9, CD206, and NOS2 gene expression was similar in all AT compartments in CHD and CTRLs, as were also L-Gal9 and CD206 circulating levels, while NOS2 serum levels were higher in CHD (p = 0.012 vs. CTRLs). In CTRLs, NOS2 expression was lower in EAT vs. SAT (p = 0.007), while in CHD patients CD206 expression was lower in both SAT and EAT as compared to PAT (p = 0.003, p = 0.006, respectively), suggestive of a possible macrophage reprogramming toward a pro-inflammatory phenotype in EAT. In CHD patients, NOS2 expression in SAT correlated to that in PAT and EAT (p = 0.007, both), CD206 expression correlated positively to L-Gal9 (p < 0.001) only in EAT, and CD206 expression associated with that of macrophage identifying markers in all AT compartments (p < 0.001, all). In CHD patients, subjects with LDL-C above 1.8 mmol/L showed significantly higher NOS2 expression in PAT and EAT as compared to subjects with LDL-C levels below (p < 0.05), possibly reflecting increased cardiac AT pro-inflammatory activation. In SAT and PAT, CD206 expression associated with BMI in both CHD and CTRLs (p < 0.05, all), and with L-Gal9 in EAT, however only in CTRLs (p = 0.002). Conclusion CHD seems to be accompanied by an altered cardiac, and especially epicardial AT macrophage polarization. This may represent an important pathophysiological mechanism and a promising field of therapy targeting the excessive AT inflammation, in need of further investigation.
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Affiliation(s)
- Bianca Papotti
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway
- Department of Food and Drug, University of Parma, Parma, Italy
- *Correspondence: Bianca Papotti,
| | - Trine Baur Opstad
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Sissel Åkra
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway
| | - Theis Tønnessen
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | - Bjørn Braathen
- Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | - Charlotte Holst Hansen
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway
| | - Harald Arnesen
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Svein Solheim
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway
| | - Ingebjørg Seljeflot
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nicoletta Ronda
- Department of Food and Drug, University of Parma, Parma, Italy
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Opstad TB, Alexander J, Aaseth JO, Larsson A, Seljeflot I, Alehagen U. Selenium and Coenzyme Q 10 Intervention Prevents Telomere Attrition, with Association to Reduced Cardiovascular Mortality-Sub-Study of a Randomized Clinical Trial. Nutrients 2022; 14:nu14163346. [PMID: 36014852 PMCID: PMC9412367 DOI: 10.3390/nu14163346] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/05/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022] Open
Abstract
Short telomeres have been associated with ageing and cardiovascular disease. The influence on leukocyte telomere length (LTL) of long-term intervention with combined selenium and coenzyme Q10 is unknown. Our aim was to determine whether 42 months of selenium and coenzyme Q10 supplementation prevented telomere attrition and further cardiovascular mortality. The investigation is an explorative sub-study of a double-blind, placebo-controlled, randomized trial. Swedish citizens low in selenium (n = 118), aged 70−80 years, were included. Intervention time was 4 years, with 10 years’ follow-up time. LTL was relatively quantified with PCR at baseline and after 42 months. At baseline, LTL (SD) was 0.954 (0.260) in the active treatment group and 1.018 (0.317) in the placebo group (p = 0.23). At 42 months, less shortening of LTL was observed after active treatment compared with placebo (+0.019 vs. −0.129, respectively, p = 0.02), with a significant difference in change basing the analysis on individual changes in LTL (p < 0.001). Subjects suffering future death presented with significantly shorter LTL at 42 months than survivors [0.791 (0.190) vs. 0.941 (0.279), p = 0.01], with a significant difference in change of LTL according to cardiovascular mortality and survival (p = 0.03). To conclude, preservation of LTL after selenium and coenzyme Q10 supplementation associated with reduced cardiovascular mortality.
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Affiliation(s)
- Trine Baur Opstad
- Centre for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, 0450 Oslo, Norway
- Faculty of Medicine, University of Oslo, 0315 Oslo, Norway
- Correspondence:
| | - Jan Alexander
- Norwegian Institute of Public Health, 0213 Oslo, Norway
| | - Jan O. Aaseth
- Department of Research, Innlandet Hospital Trust, 2381 Brumunddal, Norway
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, 2624 Lillehammer, Norway
| | - Anders Larsson
- Department of Medical Sciences, Uppsala University, 752 36 Uppsala, Sweden
| | - Ingebjørg Seljeflot
- Centre for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, 0450 Oslo, Norway
- Faculty of Medicine, University of Oslo, 0315 Oslo, Norway
| | - Urban Alehagen
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, 581 83 Linköping, Sweden
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Opstad TB, Berg TJ, Holte KB, Arnesen H, Solheim S, Seljeflot I. Reduced leukocyte telomere lengths and sirtuin 1 gene expression in long-term survivors of type 1 diabetes: A Dialong substudy. J Diabetes Investig 2021; 12:1183-1192. [PMID: 33249778 PMCID: PMC8264411 DOI: 10.1111/jdi.13470] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 10/08/2020] [Accepted: 11/24/2020] [Indexed: 11/28/2022] Open
Abstract
AIMS/INTRODUCTION The shortening of leukocyte telomere length with age has been associated with coronary disease, whereas the association with type 1 diabetes is unclear. We aimed to explore telomere lengths in diabetes patients with regard to coronary artery disease, compared with healthy controls. The longevity factors sirtuin 1 and growth-differentiating factor 11 were investigated accordingly. MATERIALS AND METHODS We carried out a cross-sectional study of 102 participants with long-term type 1 diabetes and 75 controls (mean age 62 and 63 years, respectively), where 88 cases and 60 controls without diagnosed coronary artery disease completed computed tomography coronary angiography. Telomere lengths and gene expression of sirtuin 1 and growth-differentiating factor 11 were quantified in leukocytes. RESULTS Telomere lengths and sirtuin 1 were reduced in diabetes patients versus controls, medians (25th to 75th percentiles): 0.97 (0.82-1.15) versus 1.08 (0.85-1.29) and 0.88 (0.65-1.14) vs 1.01 (0.78-1.36), respectively, adjusted P < 0.05, both. Previous coronary artery disease in diabetes patients (n = 15) was associated with lower sirtuin 1 and growth-differentiating factor 11 messenger ribonucleic acid expression (adjusted P < 0.03, both). In the combined diabetes and control group, previous artery coronary disease (n = 18) presented with significantly shorter telomeres (adjusted P = 0.038). Newly diagnosed obstructive coronary artery disease, defined as >50% stenosis, was not associated with the investigated variables. CONCLUSIONS Long-term type 1 diabetes presented with reduced telomeres and sirtuin 1 expression, with additional reduction in diabetes patients with previous coronary artery disease, showing their importance for cardiovascular disease development with potential as novel biomarkers in diabetes and coronary artery disease.
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Affiliation(s)
- Trine Baur Opstad
- Department of CardiologyCenter for Clinical Heart ResearchOslo University HospitalUllevålNorway
- Faculty of MedicineInstitute of Clinical MedicineUniversity of OsloOsloNorway
| | - Tore Julsrud Berg
- Faculty of MedicineInstitute of Clinical MedicineUniversity of OsloOsloNorway
- Department of Endocrinology, Prevention and ObesityUniversity of OsloOsloNorway
| | - Kristine Bech Holte
- Faculty of MedicineInstitute of Clinical MedicineUniversity of OsloOsloNorway
- Department of Endocrinology, Prevention and ObesityUniversity of OsloOsloNorway
| | - Harald Arnesen
- Department of CardiologyCenter for Clinical Heart ResearchOslo University HospitalUllevålNorway
- Faculty of MedicineInstitute of Clinical MedicineUniversity of OsloOsloNorway
| | - Svein Solheim
- Department of CardiologyCenter for Clinical Heart ResearchOslo University HospitalUllevålNorway
- Faculty of MedicineInstitute of Clinical MedicineUniversity of OsloOsloNorway
| | - Ingebjørg Seljeflot
- Department of CardiologyCenter for Clinical Heart ResearchOslo University HospitalUllevålNorway
- Faculty of MedicineInstitute of Clinical MedicineUniversity of OsloOsloNorway
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Langseth MS, Andersen GØ, Husebye T, Arnesen H, Zucknick M, Solheim S, Eritsland J, Seljeflot I, Opstad TB, Helseth R. Neutrophil extracellular trap components and myocardial recovery in post-ischemic acute heart failure. PLoS One 2020; 15:e0241333. [PMID: 33119664 PMCID: PMC7595325 DOI: 10.1371/journal.pone.0241333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 04/09/2020] [Accepted: 10/13/2020] [Indexed: 12/17/2022] Open
Abstract
Objective The role of neutrophil extracellular traps (NETs) in acute heart failure is unknown. We recently showed that interleukin 8, a putative NETs stimulator, was associated with myocardial recovery in acute heart failure complicating ST-elevation myocardial infarction (STEMI). In this exploratory post-hoc study, we aimed to investigate the role of NETs components in relation to myocardial function and interleukin 8 in STEMI patients with symptomatic acute heart failure. Methods In 61 STEMI patients developing acute heart failure within 48 hours of successful revascularization, wall motion score index (WMSI), global longitudinal strain (GLS) and left ventricular ejection fraction (LVEF) were assessed by echocardiography at baseline and on day 5. Blood drawn at baseline and days 1, 2 and 5 was used to quantify double-stranded DNA (dsDNA), myeloperoxidase-DNA complexes (MPO-DNA) and citrullinated histone 3 (CitH3). The area under the curve (AUC) of each NETs marker and interleukin 8 was approximated for the first 5 days. Results dsDNAAUC and MPO-DNAAUC correlated significantly with change in WMSI from baseline to day 5 (rs = 0.28 for both, p≤0.05), whereas NETs AUCs did not correlate with changes in GLS and LVEF. dsDNAAUC was significantly correlated with interleukin 8AUC (r = 0.40, p = 0.003). However, mixed model regression could not identify a significant effect of the NETs components on myocardial function parameters. Conclusions In this cohort with acute heart failure complicating STEMI, NETs components were partly correlated with myocardial function and interleukin 8 levels, yet no causal relationship between NETs components and myocardial recovery could be established. Clinical trial registration ClinicalTrials.gov, identifier: NCT00324766.
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Affiliation(s)
- Miriam Sjåstad Langseth
- Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Internal Medicine, Drammen Hospital, Vestre Viken HF, Drammen, Norway
- * E-mail:
| | - Geir Øystein Andersen
- Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway
- Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Trygve Husebye
- Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Harald Arnesen
- Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Manuela Zucknick
- Oslo Centre for Biostatistics and Epidemiology, Institute for Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Svein Solheim
- Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway
- Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Jan Eritsland
- Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Ingebjørg Seljeflot
- Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Trine Baur Opstad
- Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ragnhild Helseth
- Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway
- Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
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Åkra S, Aksnes TA, Flaa A, Eggesbø HB, Opstad TB, Njerve IU, Seljeflot I. Markers of remodeling in subcutaneous adipose tissue are strongly associated with overweight and insulin sensitivity in healthy non-obese men. Sci Rep 2020; 10:14055. [PMID: 32820223 PMCID: PMC7441176 DOI: 10.1038/s41598-020-71109-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/06/2020] [Indexed: 12/21/2022] Open
Abstract
Alteration in extracellular matrix (ECM) in adipose tissues (AT) has been associated with insulin resistance, diabetes and obesity. We investigated whether selected biomarkers of ECM remodeling in AT in healthy subjects associated with the amount and distribution of AT and with glucometabolic variables. Subcutaneous AT and fasting blood samples from 103 middle-aged healthy non-obese men were used. AT gene expression and circulating levels of the biomarkers were quantified. Distribution of AT was assessed by computed tomography, separated into subcutaneous, deep subcutaneous and visceral AT. Insulin sensitivity was measured by glucose clamp technique. Metalloproteinase (MMP)-9, tissue inhibitor of MMP (TIMP)-1 and plasminogen activator inhibitor (PAI)-1 expression in AT correlated significantly to the amount of AT in all compartments (rs = 0.41-0.53, all p ≤ 0.01), and to insulin sensitivity, insulin, C-peptide, waist circumference and body mass index (BMI) (rs = 0.25-0.57, all p ≤ 0.05). MMP-9 was 5.3 fold higher in subjects with insulin sensitivity below median (p = 0.002) and 3.1 fold higher in subjects with BMI above median level (p = 0.013). In our healthy non-obese middle-aged population AT-expressed genes, central in remodeling of ECM, associated strongly with the amount of abdominal AT, overweight and insulin sensitivity, indicating AT-remodeling to play a role also in non-obese individuals. The remodeling process seems furthermore to associate significantly with glucometabolic disturbances.Trial registration: ClinicalTrials.gov, NCT01412554. Registered 9 August 2011, https://clinicaltrials.gov/ct2/show/NCT01412554?term=NCT01412554 .
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Affiliation(s)
- Sissel Åkra
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital, Ullevål, Pb 4956 Nydalen, 0424, Oslo, Norway.
| | - Tonje A Aksnes
- Section of Cardiovascular and Renal Research, Oslo University Hospital, Oslo, Norway.,Section for Interventional Cardiology, Department of Cardiology, Heart-, Lung-, and Vascular-Disease Clinic, Oslo University Hospital, Oslo, Norway
| | - Arnljot Flaa
- Section of Cardiovascular and Renal Research, Oslo University Hospital, Oslo, Norway.,Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Heidi B Eggesbø
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Trine Baur Opstad
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital, Ullevål, Pb 4956 Nydalen, 0424, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ida U Njerve
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital, Ullevål, Pb 4956 Nydalen, 0424, Oslo, Norway
| | - Ingebjørg Seljeflot
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital, Ullevål, Pb 4956 Nydalen, 0424, Oslo, Norway.,Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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Opstad TB, Kalstad AA, Holte KB, Berg TJ, Solheim S, Arnesen H, Seljeflot I. Shorter Leukocyte Telomere Lengths in Healthy Relatives of Patients with Coronary Heart Disease. Rejuvenation Res 2020; 23:324-332. [PMID: 31805818 DOI: 10.1089/rej.2019.2258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Telomere length (TL), sirtuin (SIRT) 1, growth differentiation factor (GDF) 11, as well as inflammaging have been related to age-related diseases. In healthy subjects, we aimed to investigate whether leukocyte TL (LTL) associated with family history of coronary heart disease (CHD), age, sex, and lifestyle, and further potential covariations between LTL, GDF11, SIRT1 and selected proinflammatory markers. In 118 healthy subjects (18-81 years, 58% females), whole blood was collected for DNA and RNA isolation and polymerase chain reaction relative quantification of LTLs and gene-expression of SIRT1, GDF11, interleukin (IL)-18, and interferon (IFN)ƴ, respectively, and serum SIRT1 and IL-18 analyses. Shorter LTLs were associated with a seven-fold higher frequency of hereditary CHD in subjects with LTLs in quartile (Q)1 compared with Q2-4 (odds ratio = 7.5, 95% confidence interval: 2.5-21.6, p < 0.001, adjusted). We also observed that LTLs in Q4 compared with Q1-3 associated with higher leukocyte expression of SIRT1 and GDF11 (p = 0.052 and p = 0.058), lower IFNƴ expression (p = 0.009), and lower circulating IL-18 levels (p = 0.027). SIRT1 and GDF11 expression were strongly intercorrelated (Spearman's rho = 0.85, p < 0.001). Overall, smoking, snus, and alcohol consumption were not associated with LTLs. The observed shorter LTLs in association with elevated expression of SIRT1 and GDF11 and dampened inflammation in hereditary CHD subjects, suggest impending risk of disease. More research are warranted to shed light on early lifestyle interventions targeting these mechanisms, to promote healthier aging in individuals with hereditary burden. Graphical Abstract [Figure: see text].
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Affiliation(s)
- Trine Baur Opstad
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital, Ullevål, Oslo, Norway.,Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Are A Kalstad
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital, Ullevål, Oslo, Norway.,Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kristine Beck Holte
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Endocrinology, Prevention, and Obesity, University of Oslo, Oslo, Norway
| | - Tore Julsrud Berg
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Endocrinology, Prevention, and Obesity, University of Oslo, Oslo, Norway
| | - Svein Solheim
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital, Ullevål, Oslo, Norway.,Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway
| | - Harald Arnesen
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital, Ullevål, Oslo, Norway.,Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingebjørg Seljeflot
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital, Ullevål, Oslo, Norway.,Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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Åkra S, Aksnes TA, Flaa A, Eggesbø HB, Opstad TB, Njerve IU, Seljeflot I. Interleukin-18 and the NLR family pyrin domain containing-3 inflammasome in adipose tissue are strongly associated with glucometabolic variables in a cohort of middle-aged men. Diab Vasc Dis Res 2018; 15:458-464. [PMID: 29972041 DOI: 10.1177/1479164118785307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Previous studies have indicated an association between interleukin-18 and glucose. Interleukin-18 becomes active when cleaved by caspase-1, activated by the NLR family pyrin domain containing-3 inflammasome. AIM To investigate associations between glucometabolic variables and serum levels of interleukin-18 and genetic expression of interleukin-18, caspase-1 and NLR family pyrin domain containing-3 in adipose tissue and circulating leukocytes, and whether these mediators are related to the amount of abdominal adipose tissue . MATERIALS AND METHODS Fasting blood samples and subcutaneous adipose tissue were collected in a cohort of 103 middle-aged men. Serum levels of interleukin-18 were determined by enzyme-linked immunosorbent assay, gene expression by real-time polymerase chain reaction and insulin sensitivity by glucose clamp. The distribution of abdominal adipose tissue, separated into superficial- and deep subcutaneous, and visceral adipose tissue, was assessed by computed tomography scan. RESULTS Glucometabolic variables correlated significantly to serum levels of interleukin-18, and to the expression of interleukin-18 and NLR family pyrin domain containing-3 in subcutaneous adipose tissue ( p < 0.05). Significant correlations were further observed between the amount of fat in the different compartments of abdominal adipose tissue and both serum levels of interleukin-18 and genetic expression of interleukin-18 and NLR family pyrin domain containing-3 in adipose tissue. CONCLUSION The results implicate that the glucometabolic state is of importance for the inflammasome-related inflammation expressed both circulatory and genetically in subcutaneous adipose tissue, the latter highly reflected in the amount of abdominal adipose tissue.
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Affiliation(s)
- Sissel Åkra
- 1 Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Tonje A Aksnes
- 2 Section of Cardiovascular and Renal Research, Oslo University Hospital, Oslo, Norway
- 3 Section for Interventional Cardiology, Department of Cardiology, Heart-, Lung-, and Vascular-Disease Clinic, Oslo University Hospital, Oslo, Norway
| | - Arnljot Flaa
- 2 Section of Cardiovascular and Renal Research, Oslo University Hospital, Oslo, Norway
- 4 Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Heidi B Eggesbø
- 5 Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Trine Baur Opstad
- 1 Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway
- 6 Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ida U Njerve
- 1 Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Ingebjørg Seljeflot
- 1 Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway
- 4 Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway
- 6 Faculty of Medicine, University of Oslo, Oslo, Norway
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Langseth MS, Helseth R, Ritschel V, Solheim S, Arnesen H, Eritsland J, Andersen GØ, Halvorsen S, Seljeflot I, Opstad TB. 3402Markers of neutrophil extracellular traps as related to mortality in patients with ST-elevation myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3402] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M S Langseth
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - R Helseth
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - V Ritschel
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - S Solheim
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - H Arnesen
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - J Eritsland
- Oslo University Hospital, Department of Cardiology Ullevål, Oslo, Norway
| | - G Ø Andersen
- Oslo University Hospital, Department of Cardiology Ullevål, Oslo, Norway
| | - S Halvorsen
- Oslo University Hospital, Department of Cardiology Ullevål, Oslo, Norway
| | - I Seljeflot
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - T B Opstad
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
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Helseth R, Knudsen EC, Andersen GØ, Opstad TB, Eritsland J, Arnesen H, Seljeflot I. P2673Neutrophil extracellular traps (NETs) assessed by dsDNA and PAD4 mRNA in patients with ST-elevation myocardial infarction are associated with plasma glucose. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2673] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- R Helseth
- Oslo University Hospital, Center for Clinical Heart Research, Oslo, Norway
| | - E C Knudsen
- Oslo University Hospital, Department of Cardiology, Oslo, Norway
| | - G Ø Andersen
- Oslo University Hospital, Department of Cardiology, Oslo, Norway
| | - T B Opstad
- Oslo University Hospital, Center for Clinical Heart Research, Oslo, Norway
| | - J Eritsland
- Oslo University Hospital, Department of Cardiology, Oslo, Norway
| | - H Arnesen
- Oslo University Hospital, Center for Clinical Heart Research, Oslo, Norway
| | - I Seljeflot
- Oslo University Hospital, Center for Clinical Heart Research, Oslo, Norway
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Opstad TB, Kalstad AA, Pettersen AÅ, Arnesen H, Seljeflot I. P256Telomere lengths and the rejuvenating factor GDF11 in coronary artery disease. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.177] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T B Opstad
- Center for Clinical Heart Research, Oslo University Hospital, Ulleval, Oslo, Norway
| | - A A Kalstad
- Center for Clinical Heart Research, Oslo University Hospital, Ulleval, Oslo, Norway
| | - AÅ Pettersen
- Center for Clinical Heart Research, Oslo University Hospital, Ulleval, Oslo, Norway
| | - H Arnesen
- Center for Clinical Heart Research, Oslo University Hospital, Ulleval, Oslo, Norway
| | - I Seljeflot
- Center for Clinical Heart Research, Oslo University Hospital, Ulleval, Oslo, Norway
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Langseth MS, Opstad TB, Bratseth V, Solheim S, Arnesen H, Pettersen AA, Seljeflot I, Helseth RM. P482Markers of neutrophil extracellular traps are associated with adverse clinical outcome in patients with stable coronary artery disease. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.339] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M S Langseth
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - T B Opstad
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - V Bratseth
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - S Solheim
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - H Arnesen
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - A A Pettersen
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - I Seljeflot
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - R M Helseth
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
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Langseth MS, Opstad TB, Bratseth V, Solheim S, Arnesen H, Pettersen AÅ, Seljeflot I, Helseth R. Markers of neutrophil extracellular traps are associated with adverse clinical outcome in stable coronary artery disease. Eur J Prev Cardiol 2018; 25:762-769. [PMID: 29473463 DOI: 10.1177/2047487318760618] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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] [Indexed: 01/24/2023]
Abstract
Background Neutrophil extracellular traps, comprising chromatin and granule proteins, have been implicated in atherothrombosis. Design and methods We investigated whether the circulating neutrophil extracellular traps markers, double-stranded DNA and myeloperoxidase-DNA were associated with clinical outcome and hypercoagulability in patients with stable coronary artery disease. Patients with angiographically verified stable coronary artery disease ( n = 1001) were included. Follow-up was 2 years, recording 106 clinical endpoints (unstable angina, non-haemorrhagic stroke, myocardial infarction or death). Serum collected at baseline was used to determine double-stranded DNA and myeloperoxidase-DNA levels. Results The neutrophil extracellular traps markers were weakly intercorrelated ( r = 0.103, P = 0.001). Patients with the highest quartile of double-stranded DNA had weakly but significantly elevated hypercoagulability markers (prothrombin fragment 1+2, D-dimer, free and total tissue factor pathway inhibitor ( P < 0.001 for all)). Men, smokers, patients with metabolic syndrome and patients with a previous myocardial infarction had significantly elevated double-stranded DNA levels ( P ≤ 0.002 for all). Significantly higher double-stranded DNA levels were observed in the group experiencing a clinical endpoint compared to the group without ( P = 0.019). When categorising double-stranded DNA into quartiles, a distinct cut-off between the lowest and upper three quartiles was observed. Adjusting for relevant covariates, patients in the upper three quartiles had an odds ratio of 2.01 (95% confidence interval 1.12, 3.58, P = 0.019) for experiencing a clinical endpoint. Myeloperoxidase-DNA was not significantly associated with clinical outcome or hypercoagulability. Conclusions Double-stranded DNA levels were significantly related to adverse clinical outcome after 2 years, but only weakly associated with hypercoagulability. These observations suggest that the detrimental effects of neutrophil extracellular traps in coronary artery disease might extend beyond those related to hypercoagulability.
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Affiliation(s)
- Miriam Sjåstad Langseth
- 1 Center for Clinical Heart Research, Oslo University Hospital Ullevål, Norway.,2 Faculty of Medicine, University of Oslo, Norway
| | - Trine Baur Opstad
- 1 Center for Clinical Heart Research, Oslo University Hospital Ullevål, Norway.,2 Faculty of Medicine, University of Oslo, Norway
| | - Vibeke Bratseth
- 1 Center for Clinical Heart Research, Oslo University Hospital Ullevål, Norway.,2 Faculty of Medicine, University of Oslo, Norway
| | - Svein Solheim
- 1 Center for Clinical Heart Research, Oslo University Hospital Ullevål, Norway.,3 Department of Cardiology, Oslo University Hospital Ullevål, Norway
| | - Harald Arnesen
- 1 Center for Clinical Heart Research, Oslo University Hospital Ullevål, Norway.,2 Faculty of Medicine, University of Oslo, Norway
| | - Alf Åge Pettersen
- 1 Center for Clinical Heart Research, Oslo University Hospital Ullevål, Norway.,4 Department of Cardiology, Ringerike Hospital, Norway
| | - Ingebjørg Seljeflot
- 1 Center for Clinical Heart Research, Oslo University Hospital Ullevål, Norway.,2 Faculty of Medicine, University of Oslo, Norway.,3 Department of Cardiology, Oslo University Hospital Ullevål, Norway
| | - Ragnhild Helseth
- 1 Center for Clinical Heart Research, Oslo University Hospital Ullevål, Norway.,2 Faculty of Medicine, University of Oslo, Norway
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Opstad TB, Seljeflot I, Bøhmer E, Arnesen H, Halvorsen S. MMP-9 and Its Regulators TIMP-1 and EMMPRIN in Patients with Acute ST-Elevation Myocardial Infarction: A NORDISTEMI Substudy. Cardiology 2017; 139:17-24. [PMID: 29141241 DOI: 10.1159/000481684] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 07/13/2017] [Accepted: 09/20/2017] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The extracellular matrix is involved in wound repair after acute myocardial infarction (AMI). We investigated whether matrix metalloproteinase (MMP)-9, tissue inhibitor of metalloproteinases (TIMP)-1, and the MMP inducer (EMMPRIN) are associated with infarct size, left ventricular function, and clinical outcome in ST-elevation-MI (STEMI). METHODS In 243 STEMI patients, circulating EMMPRIN, MMP-9, and TIMP-1 were analyzed 3 days and 3 months post-AMI. Infarct size and left ventricular ejection fraction were assessed by single-photon emission computed tomography (SPECT) (n = 230/226) and MRI (n = 111/167) at 3 months. RESULTS EMMPRIN, MMP-9, and TIMP-1 levels and the MMP-9/TIMP-1 ratio declined from day 3 to 3 months (p < 0.001, all). TIMP-1 levels at day 3 correlated significantly with SPECT- and MRI-based infarct size, troponin T (p < 0.04, all), and amino-terminal pro-B-type natriuretic peptide (NT-proBNP; p < 0.001). The upper quartile of day 3 TIMP-1 levels showed an adjusted odds ratio of 5.0 (95% confidence interval 1.2-20.6) for having a large infarct size. An insignificant relationship between MMP-9 and clinical events within 1 year (death, AMI, or stroke) (n = 15) was observed, probably due to the lack of statistical power. CONCLUSION The decline in EMMPRIN, MMP-9, and TIMP-1 3 months after acute STEMI is probably due to initial acute-phase processes. The associations between TIMP-1, infarct size, and NT-proBNP indicate a role for TIMP-1 in cardiac remodeling.
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Affiliation(s)
- Trine Baur Opstad
- Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway
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Åkra S, Skårn SN, Opstad TB, Aksnes TA, Seljeflot I. Gene expression of IL-18 and NLRP3 in adipose tissue strongly associate with glucometabolic variables and with the amount of abdominal adipose tissue assessed by CT. Atherosclerosis 2017. [DOI: 10.1016/j.atherosclerosis.2017.06.051] [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: 11/15/2022]
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Opstad TB, Brusletto BS, Arnesen H, Pettersen AÅ, Seljeflot I. Cigarette smoking represses expression of cytokine IL-12 and its regulator miR-21-An observational study in patients with coronary artery disease. Immunobiology 2016; 222:169-175. [PMID: 27765464 DOI: 10.1016/j.imbio.2016.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 04/13/2016] [Revised: 09/19/2016] [Accepted: 10/12/2016] [Indexed: 12/16/2022]
Abstract
RATIONALE The heterodimer IL-12 is an inducer of Th1 responses and stimulates INFƴ production. Micro-RNA-21 (miR-21) is described as a key regulator of the pro-inflammatory response and has IL-12p35 mRNA as one of its main targets. The IL-12p40 1188A/C genetic variant located in 3'untranslated region (UTR), thus environmentally exposed, has further been reported to modify IL-12 levels. We have previously reported on the lowering effect of cigarette smoke on circulating IL-12 in patients with coronary artery disease (CAD). OBJECTIVES To explore if cigarette smoking affects IL-12p35, IL-12p40, INFƴ and miR-21 gene-expression and further modulates any effect of the IL-12p40 polymorphism on circulating IL-12 levels. METHODS AND RESULTS The IL-12p40 1188A/C polymorphism was analyzed in 1001 stable CAD patients, of which 330 subjects were included for IL-12p35, IL-12p40 and INFƴ gene-expression analyses in circulating leukocytes and 200 were further selected for plasma miR-21 analysis. Smoking associated with lower expression of miR-21 and its target IL-12p35 mRNA (adjusted p<0.05, both) whereas the influence on INFƴ expression tended to be high-dose reliant (p = 0.057). The IL-12p40 CC genotype associated with elevated circulating IL-12 levels, however, when stratified according to smoking, only in the non-smoking group (adjusted p < 0.05). Although the markers were mainly downregulated in current smokers, their inter-correlations were potentiated. CONCLUSION Smoking associated with reduced miR-21 gene-repression and the results can therefore not explain the previously observed reduction in circulating IL-12. Smoking attenuated the IL-12 pro-inflammatory axis in which the investigated IL-12p40 genetic variant may have different clinical impact in smokers vs non-smokers.
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Affiliation(s)
- T B Opstad
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevål, Norway; Center for Heart Failure Research, Oslo University Hospital, Norway; Faculty of Medicine, University of Oslo, Norway.
| | - B S Brusletto
- Department of Medical Biochemistry, Oslo University Hospital, Ullevål, Norway
| | - H Arnesen
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevål, Norway; Center for Heart Failure Research, Oslo University Hospital, Norway; Faculty of Medicine, University of Oslo, Norway
| | - A Å Pettersen
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevål, Norway; Center for Heart Failure Research, Oslo University Hospital, Norway
| | - I Seljeflot
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevål, Norway; Center for Heart Failure Research, Oslo University Hospital, Norway; Faculty of Medicine, University of Oslo, Norway
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Opstad TB, Arnesen H, Pettersen AÅ, Seljeflot I. Combined Elevated Levels of the Proinflammatory Cytokines IL-18 and IL-12 Are Associated with Clinical Events in Patients with Coronary Artery Disease: An Observational Study. Metab Syndr Relat Disord 2016; 14:242-8. [PMID: 27058587 DOI: 10.1089/met.2015.0130] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Interleukin (IL)-18 in synergy with IL-12 is critical in the initiation and progression of Th-1-type responses. IL-18 and IL12 elevation has been associated with atherosclerosis, and their interaction is hypothesized to partly be driven by glucose. We aimed to explore if simultaneous elevation of IL-18 and IL-12, as related to glucose levels, would influence the prognosis in coronary artery disease (CAD). METHOD Patients (n = 1001) with angiographically verified stable CAD were investigated (78% men, mean age 62 years, 20% current smokers). IL-18 and IL-12 were measured by conventional ELISA methods. High fasting glucose (FG) was defined as the 75 percentile, that is, >6.2 mmol/L. RESULTS After 2-year follow-up, 100 cardiovascular endpoints (fatal and nonfatal acute myocardial infarction, unstable angina, and stroke) were recorded. Subjects with simultaneous (not separate) levels in upper tertiles of both markers were at higher risk of cardiovascular events, compared to subjects in lowest tertile of both (odds ratio = 1.70, 95% confidence interval 1.11-2.61, adjusted P = 0.016), with no influence of high FG. Hyperglycemia associated with higher IL-18 levels (adjusted P = 0.009) and IL-12 levels was considerably lower in current smokers (adjusted P < 0.001). CONCLUSION Simultaneous elevated circulating levels of IL-18 and IL-12 increased the event rate after 2 years in CAD patients, independent of hyperglycemia.
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Affiliation(s)
- Trine Baur Opstad
- 1 Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway .,2 Center for Heart Failure Research, Oslo University Hospital , Oslo, Norway .,3 Faculty of Medicine, University of Oslo , Oslo, Norway
| | - Harald Arnesen
- 1 Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway .,2 Center for Heart Failure Research, Oslo University Hospital , Oslo, Norway .,3 Faculty of Medicine, University of Oslo , Oslo, Norway
| | - Alf Åge Pettersen
- 1 Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway .,2 Center for Heart Failure Research, Oslo University Hospital , Oslo, Norway
| | - Ingebjørg Seljeflot
- 1 Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway .,2 Center for Heart Failure Research, Oslo University Hospital , Oslo, Norway .,3 Faculty of Medicine, University of Oslo , Oslo, Norway
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Helseth R, Weiss TW, Opstad TB, Siegbahn A, Solheim S, Freynhofer MK, Huber K, Arnesen H, Seljeflot S. Associations between circulating proteins and corresponding genes expressed in coronary thrombi in patients with acute myocardial infarction. Thromb Res 2015; 136:1240-4. [PMID: 26475405 DOI: 10.1016/j.thromres.2015.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 09/22/2015] [Accepted: 10/04/2015] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Several genes are expressed in aspirated coronary thrombi in acute myocardial infarction (AMI), exhibiting dynamic changes along ischemic time. Whether soluble biomarkers reflect the local gene environment and ischemic time is unclear. We explored whether circulating biomarkers were associated with corresponding coronary thrombi genes and total ischemic time. MATERIAL AND METHODS In 33 AMI patients undergoing percutaneous coronary intervention (PCI), blood samples were collected within 6-24h for markers related to plaque rupture (metalloproteinase 9, tissue inhibitor of metalloproteinases 1), platelet and endothelial cell activation (P-selectin, CD40 ligand, PAR-1), hemostasis (tissue factor, tissue plasminogen activator, plasminogen activator inhibitor 1, free and total tissue factor pathway inhibitor, D-dimer, prothrombin fragment 1+2), inflammation (interleukin 8 and 18, fractalkine, monocyte chemoattractant protein 1 (MCP-1), CXCL1, pentraxin 3, myeloperoxidase) and galectin 3, caspase 8 and epidermal growth factor (EGF). Laboratory analyses were performed by Proximity Extension Assay (Proseek Multiplex CVD I(96 × 96)), ELISAs and RT-PCR. RESULTS Only circulating P-selectin correlated to the corresponding P-selectin gene expression in thrombi (r=0.530, p=0.002). Plasma galectin 3, fractalkine, MCP-1 and caspase 8 correlated inversely to ischemic time (r=-0.38-0.50, all p <0.05), while plasma MCP-1, galectin 3 and EGF were higher at short (≤ 4 h) vs. long (>4h) ischemic time (all p <0.05). CONCLUSIONS The dynamic changes in circulating mediators along ischemic time were not reflected in the profile of locally expressed genes. These observations indicate a locally confined milieu within the site of atherothrombosis, which may be important for selective therapy.
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Affiliation(s)
- Ragnhild Helseth
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Thomas W Weiss
- Department of Cardiology and Intensive Care Medicine, Wilhelminen Hospital, Vienna,Austria
| | - Trine Baur Opstad
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Agneta Siegbahn
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, University Hospital Uppsala, Uppsala, Sweden
| | - Svein Solheim
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Matthias K Freynhofer
- Department of Cardiology and Intensive Care Medicine, Wilhelminen Hospital, Vienna,Austria
| | - Kurt Huber
- Department of Cardiology and Intensive Care Medicine, Wilhelminen Hospital, Vienna,Austria
| | - Harald Arnesen
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Seljeflot Seljeflot
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway
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Njerve IU, Pettersen AÅ, Opstad TB, Arnesen H, Seljeflot I. Fractalkine and its receptor (CX3CR1) in patients with stable coronary artery disease and diabetes mellitus. Metab Syndr Relat Disord 2012; 10:400-6. [PMID: 22897138 DOI: 10.1089/met.2012.0052] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Fractalkine and its receptor CX3CR1 are associated with atherosclerosis. In vitro studies have shown increased expression of fractalkine in endothelial and vascular smooth muscle cells when stimulated with a high concentration of glucose. Increased serum levels of fractalkine have been shown in patients with type 2 diabetes mellitus (T2DM) and also in unstable coronary artery disease (CAD) patients. We investigated whether CAD patients with T2DM or metabolic syndrome have increased circulating and gene expression levels of fractalkine compared to CAD patients without these conditions. METHODS Serum levels of fractalkine were analyzed by the enzyme-linked immunosorbent assay (ELISA) method in 1001 patients with angiographically verified CAD, of which 200 had T2DM and 244 had metabolic syndrome. All patients were taking aspirin as an antithrombotic treatment. Gene expression of fractalkine and CX3CR1 in circulating leukocytes was explored in a subset of patients (n=168). RESULTS We found no significant difference in circulating levels of fractalkine in patients with T2DM [653 (556, 775) pg/mL] compared to patients without T2DM [646 (553, 761) pg/mL], p=0.50. There was also no difference between patients with and without metabolic syndrome (p=0.60). Fractalkine was not expressed in circulating leukocytes, and CX3CR1 was not expressed differently between any of the groups (p=0.13 and p=0.32, respectively). Smokers had lower fractalkine levels (p<0.001), and patients on angiotensin II receptor blockers had higher levels (p=0.047) compared to nonaffected patients. CONCLUSIONS In the present CAD population, no differences in circulating levels of fractalkine or expression levels of CX3CR1 were observed between patients with and without T2DM, or with and without metabolic syndrome, which may be related to their underlying disease.
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Affiliation(s)
- Ida Unhammer Njerve
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevaal, Oslo, Norway.
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