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Fransson C, Barlow MJ, Kavanagh PJ, Larsson J, Jones OC, Sargent B, Meixner M, Bouchet P, Temim T, Wright GS, Blommaert JADL, Habel N, Hirschauer AS, Hjorth J, Lenkić L, Tikkanen T, Wesson R, Coulais A, Fox OD, Gastaud R, Glasse A, Jaspers J, Krause O, Lau RM, Nayak O, Rest A, Colina L, van Dishoeck EF, Güdel M, Henning T, Lagage PO, Östlin G, Ray TP, Vandenbussche B. Emission lines due to ionizing radiation from a compact object in the remnant of Supernova 1987A. Science 2024; 383:898-903. [PMID: 38386759 DOI: 10.1126/science.adj5796] [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] [Received: 07/06/2023] [Accepted: 01/12/2024] [Indexed: 02/24/2024]
Abstract
The nearby Supernova 1987A was accompanied by a burst of neutrino emission, which indicates that a compact object (a neutron star or black hole) was formed in the explosion. There has been no direct observation of this compact object. In this work, we observe the supernova remnant with JWST spectroscopy, finding narrow infrared emission lines of argon and sulfur. The line emission is spatially unresolved and blueshifted in velocity relative to the supernova rest frame. We interpret the lines as gas illuminated by a source of ionizing photons located close to the center of the expanding ejecta. Photoionization models show that the line ratios are consistent with ionization by a cooling neutron star or a pulsar wind nebula. The velocity shift could be evidence for a neutron star natal kick.
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Affiliation(s)
- C Fransson
- Department of Astronomy, Stockholm University, The Oskar Klein Centre, AlbaNova, SE-106 91 Stockholm, Sweden
| | - M J Barlow
- Department of Physics and Astronomy, University College London, London WC1E 6BT, UK
| | - P J Kavanagh
- Department of Experimental Physics, Maynooth University, Maynooth, County Kildare, Ireland
- Astronomy & Astrophyics Section, School of Cosmic Physics, Dublin Institute for Advanced Studies, Dublin 2, Ireland
| | - J Larsson
- Department of Physics, KTH Royal Institute of Technology, The Oskar Klein Centre, AlbaNova, SE-106 91 Stockholm, Sweden
| | - O C Jones
- UK Astronomy Technology Centre, Royal Observatory, Blackford Hill, Edinburgh EH9 3HJ, UK
| | - B Sargent
- Space Telescope Science Institute, Baltimore, MD 21218, USA
- Department of Physics and Astronomy, The Johns Hopkins University, Baltimore, MD 21218, USA
| | - M Meixner
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - P Bouchet
- Université Paris-Saclay, Université Paris Cité, Commissariat à l'Énergie Atomique et aux Énergies Alternatives, Centre National de la Recherche Scientifique, Astrophysique Instrumentation Modélisation, Saint Aubin, France
| | - T Temim
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544, USA
| | - G S Wright
- UK Astronomy Technology Centre, Royal Observatory, Blackford Hill, Edinburgh EH9 3HJ, UK
| | - J A D L Blommaert
- Astronomy and Astrophysics Research Group, Department of Physics and Astrophysics, Vrije Universiteit Brussel, B-1050 Brussels, Belgium
| | - N Habel
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - A S Hirschauer
- Space Telescope Science Institute, Baltimore, MD 21218, USA
| | - J Hjorth
- Dark Cosmology Centre, Niels Bohr Institute, University of Copenhagen, 2200 Copenhagen, Denmark
| | - L Lenkić
- Stratospheric Observatory for Infrared Astronomy Science Center, Universities Space Research Association, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - T Tikkanen
- School of Physics and Astronomy, Space Research Centre, Space Park Leicester, University of Leicester, Leicester LE4 5SP, UK
| | - R Wesson
- School of Physics and Astronomy, Cardiff University, Cardiff CF24 3AA, UK
| | - A Coulais
- Université Paris-Saclay, Université Paris Cité, Commissariat à l'Énergie Atomique et aux Énergies Alternatives, Centre National de la Recherche Scientifique, Astrophysique Instrumentation Modélisation, Saint Aubin, France
- Laboratoire d'Etudes du Rayonnement et de la Matière en Astrophysique et Atmosphères, Observatoire de Paris, Paris Sciences et Lettres Research University, National Centre for Scientific Research, Sorbonne Université, Paris, France
| | - O D Fox
- Space Telescope Science Institute, Baltimore, MD 21218, USA
| | - R Gastaud
- Université Paris-Saclay, Commissariat à l'Énergie Atomique et aux Énergies Alternatives, Detectors Electronics and Computing for Physics, Gif-sur-Yvette, France
| | - A Glasse
- UK Astronomy Technology Centre, Royal Observatory, Blackford Hill, Edinburgh EH9 3HJ, UK
| | - J Jaspers
- Department of Experimental Physics, Maynooth University, Maynooth, County Kildare, Ireland
- Astronomy & Astrophyics Section, School of Cosmic Physics, Dublin Institute for Advanced Studies, Dublin 2, Ireland
| | - O Krause
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - R M Lau
- National Optical-Infrared Astronomy Research Laboratory, National Science Foundation, Tucson, AZ 85719, USA
| | - O Nayak
- NASA Goddard Space Flight Center, Greenbelt, MD 20770, USA
| | - A Rest
- Space Telescope Science Institute, Baltimore, MD 21218, USA
- Department of Physics and Astronomy, The Johns Hopkins University, Baltimore, MD 21218, USA
| | - L Colina
- Centro de Astrobiología, Consejo Superior de Investigaciones Científicas - Instituto Nacional de Técnica Aeroespacial, Torrejón de Ardoz, E-28850, Madrid, Spain
| | - E F van Dishoeck
- Max-Planck Institut für Extraterrestrische Physik, D-85748 Garching, Germany
- Leiden Observatory, 2300 RA Leiden, Netherlands
| | - M Güdel
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
- Department of Astrophysics, University of Vienna, A-1180 Vienna, Austria
- Institute for Particle Physics and Astrophysics, Eidgenössische Technische Hochschule Zürich, 8093 Zürich, Switzerland
| | - Th Henning
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - P-O Lagage
- Université Paris-Saclay, Université Paris Cité, Commissariat à l'Énergie Atomique et aux Énergies Alternatives, Centre National de la Recherche Scientifique, Astrophysique Instrumentation Modélisation, Saint Aubin, France
| | - G Östlin
- Department of Astronomy, Stockholm University, The Oskar Klein Centre, AlbaNova, SE-106 91 Stockholm, Sweden
| | - T P Ray
- Astronomy & Astrophyics Section, School of Cosmic Physics, Dublin Institute for Advanced Studies, Dublin 2, Ireland
| | - B Vandenbussche
- Institute of Astronomy, Katholieke Universiteit Leuven, 3001 Leuven, Belgium
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Soinio M, Luukkonen AK, Seppänen M, Kemppainen J, Seppänen J, Pienimäki JP, Leijon H, Vesterinen T, Arola J, Lantto E, Helin S, Tikkanen I, Metso S, Mirtti T, Heiskanen I, Norvio L, Tiikkainen M, Tikkanen T, Sane T, Välimäki M, Gomez-Sanchez CE, Pörsti I, Nuutila P, Nevalainen PI, Matikainen N. Response to Letter on use of functional imaging by 11C-metomidate PET for primary aldosteronism subtyping. Eur J Endocrinol 2021; 184:L11-L12. [PMID: 33555271 PMCID: PMC8045446 DOI: 10.1530/eje-21-0048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/03/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Minna Soinio
- Department of Endocrinology, Turku University Hospital, Turku, Finland
- Turku PET Centre, University of Turku, Turku, Finland
| | - Anna-Kaarina Luukkonen
- Department of Internal Medicine and Tampere University, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Marko Seppänen
- Turku PET Centre, University of Turku, Turku, Finland
- Department of clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Jukka Kemppainen
- Turku PET Centre, University of Turku, Turku, Finland
- Department of clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Janne Seppänen
- Centre for Vascular Surgery and Interventional Radiology, Tampere University Hospital, Tampere, Finland
| | - Juha-Pekka Pienimäki
- Centre for Vascular Surgery and Interventional Radiology, Tampere University Hospital, Tampere, Finland
| | - Helena Leijon
- Department of Pathology, University of Helsinki and HUSLAB, Helsinki University Hospital, Helsinki, Finland
| | - Tiina Vesterinen
- Department of Pathology, University of Helsinki and HUSLAB, Helsinki University Hospital, Helsinki, Finland
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Johanna Arola
- Department of Pathology, University of Helsinki and HUSLAB, Helsinki University Hospital, Helsinki, Finland
| | - Eila Lantto
- Medical Imaging Center, Radiology, Helsinki University Hospital, Helsinki, Finland
| | - Semi Helin
- Turku PET Centre, University of Turku, Turku, Finland
| | - Ilkka Tikkanen
- Abdominal Center, Nephrology, University of Helsinki, and Helsinki University Hospital, and Minerva Institute for Medical Research, Helsinki, Finland
| | - Saara Metso
- Department of Internal Medicine and Tampere University, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Tuomas Mirtti
- Department of Pathology, University of Helsinki and HUSLAB, Helsinki University Hospital, Helsinki, Finland
- Research Program in Systems Oncology (ONCOSYS), University of Helsinki, Helsinki, Finland
| | - Ilkka Heiskanen
- Endocrine Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Leena Norvio
- Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Mirja Tiikkainen
- Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Timo Sane
- Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Matti Välimäki
- Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Celso E Gomez-Sanchez
- G.V. (Sonny) Montgomery VA Medical Center and Department of Pharmacology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Ilkka Pörsti
- Department of Internal Medicine and Tampere University, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Pirjo Nuutila
- Department of Endocrinology, Turku University Hospital, Turku, Finland
- Turku PET Centre, University of Turku, Turku, Finland
| | - Pasi I Nevalainen
- Department of Internal Medicine and Tampere University, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Niina Matikainen
- Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Research Programs Unit, Clinical and Molecular Medicine, University of Helsinki, Helsinki, Finland
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3
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Soinio M, Luukkonen AK, Seppänen M, Kemppainen J, Seppänen J, Pienimäki JP, Leijon H, Vesterinen T, Arola J, Lantto E, Helin S, Tikkanen I, Metso S, Mirtti T, Heiskanen I, Norvio L, Tiikkainen M, Tikkanen T, Sane T, Välimäki M, Gomez-Sanchez CE, Pörsti I, Nuutila P, Nevalainen PI, Matikainen N. Functional imaging with 11C-metomidate PET for subtype diagnosis in primary aldosteronism. Eur J Endocrinol 2020; 183:539-550. [PMID: 33055298 PMCID: PMC8045447 DOI: 10.1530/eje-20-0532] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/02/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Endocrine Society guidelines recommend adrenal venous sampling (AVS) in primary aldosteronism (PA) if adrenalectomy is considered. We tested whether functional imaging of adrenal cortex with 11C-metomidate (11C-MTO) could offer a noninvasive alternative to AVS in the subtype classification of PA. DESIGN We prospectively recruited 58 patients with confirmed PA who were eligible for adrenal surgery. METHODS Subjects underwent AVS and 11C-MTO-PET without dexamethasone pretreatment in random order. The lateralization of 11C-MTO-PET and adrenal CT were compared with AVS in all subjects and in a prespecified adrenalectomy subgroup in which the diagnosis was confirmed with immunohistochemical staining for CYP11B2. RESULTS In the whole study population, the concordance of AVS and 11C-MTO-PET was 51% and did not differ from that of AVS and adrenal CT (53%). The concordance of AVS and 11C-MTO-PET was 55% in unilateral and 44% in bilateral PA. In receiver operating characteristics analysis, the maximum standardized uptake value ratio of 1.16 in 11C-MTO-PET had an AUC of 0.507 (P = n.s.) to predict allocation to adrenalectomy or medical therapy with sensitivity of 55% and specificity of 44%. In the prespecified adrenalectomy subgroup, AVS and 11C-MTO-PET were concordant in 10 of 19 subjects with CYP11B2-positive adenoma and in 6 of 10 with CYP11B2-positivity without an adenoma. CONCLUSIONS The concordance of 11C-MTO-PET with AVS was clinically suboptimal, and did not outperform adrenal CT. In a subgroup with CYP11B2-positive adenoma, 11C-MTO-PET identified 53% of cases. 11C-MTO-PET appeared to be inferior to AVS for subtype classification of PA.
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Affiliation(s)
- Minna Soinio
- Department of Endocrinology, Turku University Hospital, Turku, Finland
- Turku PET Centre, University of Turku, Turku, Finland
| | - Anna-Kaarina Luukkonen
- Department of Internal Medicine and Tampere University, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Marko Seppänen
- Turku PET Centre, University of Turku, Turku, Finland
- Department of clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Jukka Kemppainen
- Turku PET Centre, University of Turku, Turku, Finland
- Department of clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Janne Seppänen
- Centre for Vascular Surgery and Interventional Radiology, Tampere University Hospital, Tampere, Finland
| | - Juha-Pekka Pienimäki
- Centre for Vascular Surgery and Interventional Radiology, Tampere University Hospital, Tampere, Finland
| | - Helena Leijon
- Department of Pathology, University of Helsinki and HUSLAB, Helsinki University Hospital, Helsinki, Finland
| | - Tiina Vesterinen
- Department of Pathology, University of Helsinki and HUSLAB, Helsinki University Hospital, Helsinki, Finland
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Johanna Arola
- Department of Pathology, University of Helsinki and HUSLAB, Helsinki University Hospital, Helsinki, Finland
| | - Eila Lantto
- Medical Imaging Center, Radiology, Helsinki University Hospital, Helsinki, Finland
| | - Semi Helin
- Turku PET Centre, University of Turku, Turku, Finland
| | - Ilkka Tikkanen
- Abdominal Center, Nephrology, University of Helsinki, and Helsinki University Hospital, and Minerva Institute for Medical Research, Helsinki, Finland
| | - Saara Metso
- Department of Internal Medicine and Tampere University, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Tuomas Mirtti
- Department of Pathology, University of Helsinki and HUSLAB, Helsinki University Hospital, Helsinki, Finland
- Research Program in Systems Oncology (ONCOSYS), University of Helsinki, Helsinki, Finland
| | - Ilkka Heiskanen
- Endocrine Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Leena Norvio
- Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Mirja Tiikkainen
- Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Timo Sane
- Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Matti Välimäki
- Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Celso E Gomez-Sanchez
- Department of Pharmacology, G.V. (Sonny) Montgomery VA Medical Center, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Ilkka Pörsti
- Department of Internal Medicine and Tampere University, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Pirjo Nuutila
- Department of Endocrinology, Turku University Hospital, Turku, Finland
- Turku PET Centre, University of Turku, Turku, Finland
| | - Pasi I Nevalainen
- Department of Internal Medicine and Tampere University, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Niina Matikainen
- Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Research Programs Unit, Clinical and Molecular Medicine, University of Helsinki, Helsinki, Finland
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Hannila-Handelberg T, Kontula K, Tikkanen I, Tikkanen T, Fyhrquist F, Helin K, Fodstad H, Piippo K, Miettinen HE, Virtamo J, Krusius T, Sarna S, Gautschi I, Schild L, Hiltunen TP. Common variants of the beta and gamma subunits of the epithelial sodium channel and their relation to plasma renin and aldosterone levels in essential hypertension. BMC Med Genet 2005; 6:4. [PMID: 15661075 PMCID: PMC547905 DOI: 10.1186/1471-2350-6-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2004] [Accepted: 01/20/2005] [Indexed: 11/25/2022]
Abstract
Background Rare mutations of the epithelial sodium channel (ENaC) result in the monogenic hypertension form of Liddle's syndrome. We decided to screen for common variants in the ENaC βand γ subunits in patients with essential hypertension and to relate their occurrence to the activity of circulating renin-angiotensin-aldosterone system. Methods Initially, DNA samples from 27 patients with low renin/low aldosterone hypertension were examined. The DNA variants were subsequently screened for in 347 patients with treatment-resistant hypertension, 175 male subjects with documented long-lasting normotension and 301 healthy
Plasma renin and aldosterone levels were measured under baseline conditions and during postural and captopril challenge tests. Results Two commonly occurring βENaC variants (G589S and a novel intronic i12-17CT substitution) and one novel γENaC variant (V546I) were detected. One of these variants occurred in a heterozygous form in 32 patients, a prevalence (9.2%) significantly higher than that in normotensive males (2.9%, p = 0.007) and blood donors (3.0%, p = 0.001). βENaC i12-17CT was significantly more prevalent in the hypertension group than in the two control groups combined (4.6% vs. 1.1%, p = 0.001). When expressed in Xenopus oocytes, neither of the two ENaC amino acid-changing variants showed a significant difference in activity compared with ENaC wild-type. No direct evidence for a mRNA splicing defect could be obtained for the βENaC intronic variant. The ratio of daily urinary potassium excretion to upright and mean (of supine and upright values) plasma renin activity was higher in variant allele carriers than in non-carriers (p = 0.034 and p = 0.048). Conclusions At least 9% of Finnish patients with hypertension admitted to a specialized center carry genetic variants of β and γENaC, a three times higher prevalence than in the normotensive individuals or in random healthy controls. Patients with the variant alleles showed an increased urinary potassium excretion rate in relation to their renin levels.
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Affiliation(s)
- Tuula Hannila-Handelberg
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Kimmo Kontula
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Ilkka Tikkanen
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Tuula Tikkanen
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Frej Fyhrquist
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Karri Helin
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Heidi Fodstad
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Kirsi Piippo
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Helena E Miettinen
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Jarmo Virtamo
- Department of Epidemiology and Health Promotion, National Public Health Institute, 00300 Helsinki, Finland
| | - Tom Krusius
- The Finnish Red Cross Blood Service, 00310 Helsinki, Finland
| | - Seppo Sarna
- Department of Public Health, University of Helsinki, 00014 Helsinki, Finland
| | - Ivan Gautschi
- Institute of Pharmacology and Toxicology, University of Lausanne, 1005 Lausanne, Switzerland
| | - Laurent Schild
- Institute of Pharmacology and Toxicology, University of Lausanne, 1005 Lausanne, Switzerland
| | - Timo P Hiltunen
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
- Helsinki University Central Hospital, Jorvi Hospital, 02740 Espoo, Finland
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Tikkanen I, Tikkanen T. [When is blood pressure lowering needed?]. Duodecim 2002; 115:945-9. [PMID: 11859528] [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: 02/23/2023]
Affiliation(s)
- I Tikkanen
- HYKS:n sisätautien klinikka PL 341, Haartmaninkatu 4 00029 HYKS.
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Tikkanen I, Tikkanen T, Cao Z, Allen TJ, Davis BJ, Lassila M, Casley D, Johnston CI, Burrell LM, Cooper ME. Combined inhibition of neutral endopeptidase with angiotensin converting enzyme or endothelin converting enzyme in experimental diabetes. J Hypertens 2002; 20:707-14. [PMID: 11910307 DOI: 10.1097/00004872-200204000-00029] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [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: 11/25/2022]
Abstract
OBJECTIVE The effects of combined inhibition of neutral endopeptidase (NEP) with either angiotensin-converting enzyme (ACE), or endothelin-converting enzyme (ECE) on blood pressure, urinary albumin excretion and heart weight were explored in experimental diabetes. DESIGN Streptozotocin-induced diabetic Sprague-Dawley rats were treated with vehicle, the NEP/ACE inhibitor S 21402, the NEP/ECE inhibitor CGS 26303, the NEP inhibitor SCH 42495, the ACE inhibitor captopril or the endothelin receptor antagonist bosentan for 4 weeks. METHODS Blood pressure was measured by tail-cuff method and radiotelemetry. Albuminuria, plasma renin activity and plasma atrial natriuretic peptide (ANP) were determined by radioimmunoassay. NEP binding was assessed by in vitro quantitative autoradiography. Metabolic and biochemistry parameters including food intake, 24-h urine volume, plasma glucose, glycated hemoglobin, glomerular filtration rate (GFR) and urinary sodium excretion were also determined. RESULTS Mean blood pressure over the 4-week study period after commencement of treatment was reduced to a similar extent by a range of treatments including the ACE inhibitor, NEP/ACE inhibitor, endothelin receptor antagonist, NEP/ECE inhibitor, but not the NEP inhibitor, compared with vehicle-treated diabetic rats. Heart to body weight ratio in diabetic rats was only reduced by the NEP/ACE and the NEP/ECE inhibitor. Increased albuminuria in diabetic rats (1.1 times/divided by 1.2 mg/day) was reduced by the NEP/ACE (0.6 times/divided by 1.2 mg/day) and the NEP/ECE inhibitors (0.4 times/divided by 1.2 mg/day). Renal NEP was reduced by the NEP/ACE inhibitor (35 +/- 4%) or NEP/ECE inhibitor (38 +/- 4%) as well as by the pure NEP inhibitor (27 +/- 4%) compared with the untreated diabetic group. Other abnormal metabolic and biochemical parameters in diabetic rats were not influenced by any drug treatment. CONCLUSIONS Combined inhibition of NEP/ACE or NEP/ECE confers beneficial effects on blood pressure, albuminuria and heart to body weight ratio in experimental diabetes.
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Affiliation(s)
- Ilkka Tikkanen
- Department of Medicine, University of Melbourne, Austin and Repatriation Medical Centre, Heidelberg, Victoria, Australia
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Mäki T, Heinäsmäki T, Riutta J, Tikkanen T, Laasonen L, Eklund K. [Bilateral Achilles tendon rupture caused by oral fluoroquinolones]. Duodecim 2001; 112:1818-20. [PMID: 10596182] [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: 02/14/2023]
Affiliation(s)
- T Mäki
- Department of Internal Medicine, Helsinki Central University Hospital, Helsinki, Finland
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8
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Abstract
OBJECTIVE Analysis of the factors influencing the outcome of performed or attempted invasive treatment for renal artery disease (RAD). SETTING University Hospital. STUDY PATIENTS Thirty-five hypertensive patients with 31 stenoses and 14 occlusions of renal artery. INTERVENTIONS Angioplasty was performed on 25 patients (attempted for 30), primary stenting on one, nephrectomy on three, and renal resection on one patient. MAIN OUTCOME MEASURE A decrease of diastolic blood pressure (DBP) by >/=15 mmHg after intervention. RESULTS A DBP response was seen in 24 patients. In 11 patients, invasive treatment did not result in a DBP response or failed technically. Compared with these patients, the responders were younger (55 +/- 11 vs. 66 +/- 8 years, P = 0.001) and tended to have higher DBP (100 +/- 8 vs. 93 +/- 11 mmHg, P = 0.065). The function of the affected kidney, or that of the more affected kidney if RAD was bilateral, was better preserved in responders (relative clearance on captopril renography 23 +/- 15 vs. 8 +/- 4%, P = 0.008). A response was more often seen in unilateral than in bilateral RAD (81% vs. 33%, P = 0.015). A relative clearance of </=10% on captopril renography had sensitivity of 88% and specificity of 81% for renal artery occlusion. Step-wise logistic analysis. (1) When DBP was< 95 mmHg with two antihypertensives, the response rate was 1/6 vs. 24/29 for more severe hypertension (P = 0.004). (2) Elderly patients had a response rate of 2/5 vs. 22/24 in younger patients (P = 0.024). (3) Response rates in bilateral and unilateral disease were not different, nor did the function of the affected kidney impact the DBP response. However, three of the four responders with </=10% relative clearance had an occluded renal artery and underwent nephrectomy. CONCLUSIONS Middle-aged patients with easily controlled hypertension and elderly hypertensives do not usually have a blood pressure response to the performed or attempted invasive treatment of RAD. Therefore, it seems recommendable not to screen such patients for RAD, unless their renal function is deteriorated. If the affected kidney functions poorly on captopril renography, angioplasty is usually not applicable and seldom leads to a blood pressure response.
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Affiliation(s)
- K H Helin
- Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland.
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Tikkanen T. Surface UV retrieval from satellite data. Int J Circumpolar Health 2000; 59:9-14. [PMID: 10850001] [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: 02/16/2023] Open
Abstract
Irradiance of biologically effective ultraviolet radiation on the Earth's surface is retrieved from satellite measurements using radiative transfer models. Retrieval methods are reviewed with a special emphasis on questions pertinent to the Arctic environment. In general, the main problem is the high variability of cloudiness. The most prominent features of high latitudes are the low Sun and the high UV reflectivity of snow-covered terrain. Being white like clouds, snow is a challenge for satellite imagery. The dependence of UV albedo on the properties of snow and ambient conditions is discussed. The use of auxiliary snow cover data from a meteorological model is planned.
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Affiliation(s)
- T Tikkanen
- Finnish Meteorological Institute, Helsinki, Finland
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10
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Uhlenius N, Tikkanen T, Miettinen A, Holthöfer H, Törnroth T, Eriksson A, Fyhrquist F, Tikkanen I. Renoprotective effects of captopril in hypertension induced by nitric oxide synthase inhibition in experimental nephritis. Nephron Clin Pract 1999; 81:221-9. [PMID: 9933759 DOI: 10.1159/000045280] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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: 11/19/2022] Open
Abstract
OBJECTIVE To investigate effects of angiotensin I converting enzyme (ACE) inhibition in experimental nephritis during chronic inhibition of nitric oxide (NO) synthase. METHODS Rats with and without autoimmune Heymann nephritis were treated with a NO synthase inhibitor L-NAME (50 mg/100 ml) and/or an ACE inhibitor captopril (20 mg/100 ml) in drinking water for 12 weeks. Urinary cGMP excretion was used as an indirect measure of NO activity. Blood pressure, urinary albumin, nitrite and nitrate levels, plasma ANP, and plasma renin activity were measured. Kidneys were examined with light microscopy and immunohistochemical methods. RESULTS Captopril treatment protected rats receiving L-NAME and none of the captopril-treated rats died. Mortality was greatest in the nephritis-L-NAME (57%) and L-NAME (43%) groups. Captopril normalized cGMP excretion, blood pressure, and prevented partly the appearance of albuminuria. Peritubular infiltration of mononuclear cells was clearly enhanced in the nephritis-L-NAME group (found in 80% of the rats) as compared with the nephritis (20%), L-NAME (40%), and control (0%) groups. The peritubular cell infiltration caused by L-NAME was prevented by captopril treatment. L-NAME-induced hypertension was associated with cardiac hypertrophy and this was prevented by captopril. CONCLUSIONS NO may play an important renoprotective role in disease progression of chronic membranous glomerulonephritis. Captopril prevents L-NAME-induced hypertension, improves survival, and ameliorates renal damage in this type of nephritis. Dysfunction of renal NO pathways may be an important factor causing progressive renal damage in chronic nephritis. Our results suggest that the dysfunctional renal NO system may be beneficially activated by ACE inhibitors.
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Affiliation(s)
- N Uhlenius
- Minerva Foundation Institute for Medical Research, Helsinki University Central Hospital, Finland
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11
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Tikkanen T, Tikkanen I, Rockell MD, Allen TJ, Johnston CI, Cooper ME, Burrell LM. Dual inhibition of neutral endopeptidase and angiotensin-converting enzyme in rats with hypertension and diabetes mellitus. Hypertension 1998; 32:778-85. [PMID: 9774379 DOI: 10.1161/01.hyp.32.4.778] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.1] [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: 11/16/2022]
Abstract
It has been suggested that combined inhibition of angiotensin-converting enzyme (ACE) and neutral endopeptidase (NEP) may lower blood pressure more effectively than either treatment alone, independent of the degree of salt and volume status or the activity of the renin-angiotensin system. The effects of NEP inhibition in hypertension associated with diabetes mellitus are largely unknown. We therefore compared ACE inhibition, NEP inhibition, and dual NEP/ACE inhibition in diabetic hypertensive rats. Spontaneously hypertensive rats (SHR) aged 9 to 10 weeks were injected with either streptozotocin (45 mg/kg) or citrate buffer and randomized to receive either the ACE inhibitor captopril (25 mg/kg BID), the NEP inhibitor SCH 42495 (30 mg/kg BID), the dual NEP/ACE inhibitor S 21402 (25 or 50 mg/kg BID), or vehicle by gavage for 4 weeks. A group of diabetic SHR was also allocated to receive the combination of SCH 42495 (30 mg/kg BID) and captopril (25 mg/kg BID). The degree of renal NEP inhibition was determined by autoradiography, and plasma renin activity (PRA) was determined by radioimmunoassay. In diabetic SHR, the dual NEP/ACE inhibitor (50 mg/kg BID), as well as the combination of the NEP inhibitor and the ACE inhibitor, reduced systolic blood pressure more effectively than the ACE inhibitor (P<0.001) or the NEP inhibitor (P<0.001) alone. In nondiabetic SHR, the dual NEP/ACE inhibitor and the ACE inhibitor were equally effective, while the NEP inhibitor had only slight blood pressure lowering effects. Relative heart weight decreased in parallel to the changes in blood pressure. Renal NEP was clearly inhibited (70% to 92%; P<0.001) by both the NEP inhibitor and the dual NEP/ACE inhibitor. Both the ACE inhibitor and the dual NEP/ACE inhibitor increased PRA, but the stimulating effect of dual NEP/ACE inhibition on PRA was less than that observed with ACE inhibition alone (P<0.05). Albuminuria in diabetic SHR was lower during treatment with both the dual NEP/ACE inhibitor (50 mg/kg BID) and the combination of NEP inhibition and ACE inhibition compared with vehicle treatment (P<0.05). In conclusion, the present study shows that hypertension in SHR with streptozotocin-induced diabetes is modulated by natriuretic peptides and thus is sensitive to NEP inhibition. The increased efficacy of dual NEP/ACE inhibition on blood pressure in diabetic SHR, compared with ACE or NEP inhibition alone, suggests that this therapeutic approach may prove beneficial in the treatment of hypertension associated with diabetes mellitus and other forms of volume-dependent hypertension.
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Affiliation(s)
- T Tikkanen
- Department of Medicine, University of Melbourne, Austin and Repatriation Medical Centre, Heidelberg, Victoria, Australia
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12
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Helin KH, Tikkanen I, von Knorring JE, Lepäntalo MJ, Liewendahl BK, Laasonen LS, Fyhrquist FY, Tikkanen T. Screening for renovascular hypertension in a population with relatively low prevalence. J Hypertens 1998; 16:1523-9. [PMID: 9814625 DOI: 10.1097/00004872-199816100-00018] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [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: 10/27/2022]
Abstract
OBJECTIVE To evaluate the accuracy and cost-efficacy of the diagnostic procedure and treatment for renovascular hypertension. SETTING AND PATIENTS A total of 519 patients referred to the university clinic for hypertension were screened for renovascular hypertension with 405 captopril challenge tests (CCT) and 450 captopril renographies (CRG). INTERVENTIONS Abdominal angiography was performed on 84 patients for positive screening. Fifteen patients underwent angiography for a sole suspicious clinical presentation. The angiography revealed 17 renal artery stenoses and five occlusions in 20 patients. Fifteen technically successful angioplasties and three nephrectomies were performed. RESULTS In the patients who underwent angiography, CCT had a specificity of 39% and a sensitivity of 67% for renovascular hypertension. CRG had a sensitivity of 100% and a specificity of 68%. In the whole study population, the estimated specificity of CCT was 88% and that of CRG 95%. Invasive treatment reduced systolic/diastolic blood pressure from 157/99 to 140/87 mmHg and the number of antihypertensive drugs used from 2.6 to 1.4 in 16 patients (mean age 49 years). Angiotensin converting enzyme (ACE) inhibition was effective in four elderly patients. Cost-efficacy analysis Screening with CRG and invasive treatment cost US$15400 per successful invasive treatment Equally effective pharmacological treatment would have cost US$10400. Limiting the screening with CRG to the 173 patients with no obvious renal parenchymal disease and with hypertension at a younger age (< or =30 years) or unresponsive to two antihypertensive drugs (diastolic blood pressure > 90 mmHg) would have yielded a prevalence of 12% and missed only one elderly patient who responded to ACE inhibition. The limited screening, along with invasive treatment, would have cost US$7300 per patient CONCLUSIONS CRG is superior to CCT for screening of renovascular hypertension. Screening with CRG is cost-effective when limited to patients with no obvious renal parenchymal disease and with hypertension that does not respond to two antihypertensive drugs or is detected in patients no older than 30 years.
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Affiliation(s)
- K H Helin
- Department of Internal Medicine, Helsinki University Central Hospital, Finland.
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13
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Tikkanen I, Tikkanen T. [Angiotensin II antagonists]. Duodecim 1997; 111:1733-5. [PMID: 9340266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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14
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Schalin-Jäntti C, Nikula-Ijäs P, Huang X, Lehto M, Knudsen P, Syvänne M, Lehtovirta MT, Tikkanen T, Tikkanen I, Groop LC. Polymorphism of the glycogen synthase gene in hypertensive and normotensive subjects. Hypertension 1996; 27:67-71. [PMID: 8591890 DOI: 10.1161/01.hyp.27.1.67] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [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: 01/31/2023]
Abstract
Hypertension and non-insulin-dependent diabetes mellitus (NIDDM) are characterized by a strong genetic component and impaired ability to store glucose as glycogen in skeletal muscle. Impaired insulin activation and altered genetic control of muscle glycogen synthase, the rate-limiting enzyme for glucose storage in skeletal muscle, could provide an explanation for this insulin resistance. We examined whether there is an association between the glycogen synthase gene (Xba I polymorphism) and hypertension in 304 nondiabetic subjects. We examined glucose tolerance with an oral glucose tolerance test and glucose storage in skeletal muscle with the euglycemic insulin clamp technique in combination with indirect calorimetry. The Xba I A2 allele of the glycogen synthase gene was enriched in subjects with hypertension and a family history of NIDDM (48%) compared with normotensive subjects without a family history of NIDDM (6%, P < .0001). The presence of the A2 versus the A1 allele was associated with decreased rates of insulin-stimulated glucose storage in hypertensive subjects (11.2 +/- 2.3 versus 16.9 +/- 2.6 mumol/kg lean body mass per minute, P = .029) but not in normotensive subjects (28.0 +/- 4.6 versus 29.6 +/- 3.7 mumol/kg lean body mass per minute). In conclusion, Xba I polymorphism of the glycogen synthase gene identifies a subgroup of hypertensive subjects with a family history of NIDDM. The data suggest that a locus in the glycogen synthase gene region on chromosome 19 may serve as a "thrifty gene," increasing susceptibility for insulin resistance when exposed to other environmental or genetic factors.
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Affiliation(s)
- C Schalin-Jäntti
- First Department of Medicine, Helsinki (Finland) University, Finland
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15
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Uhlenius N, Tikkanen I, Tikkanen T, Miettinen A, Törnroth T, Fyhrquist F. Chronic inhibition of nitric oxide synthase in Heymann nephritis. Nephron Clin Pract 1996; 74:144-9. [PMID: 8883033 DOI: 10.1159/000189294] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [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: 02/02/2023] Open
Abstract
Effects of nitric oxide (NO) synthase inhibition on blood pressure and on the course of Heymann nephritis was examined in rats. L-NG-nitroarginine-methylester (L-NAME, 10 mg/100 ml in the drinking water for 12 weeks) was used as an inhibitor of NO synthase. Urinary excretion of guanosine 3',5'-cyclic monophosphate (cGMP), a second messenger of NO, was used as an indirect estimate of NO activity. Rats were divided into the following groups: control, nephritis, L-NAME, and nephritis-L-NAME. Urinary cGMP excretion was lower in the nephritis group (p < 0.05) and in the nephritis-L-NAME group (p < 0.005) compared with controls. Plasma atrial natriuretic peptide (ANP) levels were elevated in the nephritis (p < 0.001) and in the nephritis-L-NAME groups (p < 0.05. L-NAME treatment alone did not have any effect on plasma ANP levels. Blood pressure rose progressively in all L-NAME-treated rats. Most marked albuminuria developed in the nephritis-L-NAME group. No differences in the immunohistological findings were observed between the nephritis and the nephritis-L-NAME groups. NO synthase inhibition causes hypertension and aggravates albuminuria in chronic nephritis. Moreover, nephritis itself may decrease then production of cGMP either as a consequence of blunted NO activity or, in addition, because of ANP resistance. It appears that NO synthase inhibition does not change the immunological course of Heymann nephritis but rather the increased hemodynamic load makes the course of nephritis worse.
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Affiliation(s)
- N Uhlenius
- Minerva Foundation Institute for Medical Research, Finland
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16
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Tikkanen I, Uhlenius N, Tikkanen T, Miettinen A, Törnroth T, Fyhrquist F, Holthöfer H. Increased renal expression of cytokines and growth factors induced by DOCA-NaCl treatment in Heymann nephritis. Nephrol Dial Transplant 1995; 10:2192-8. [PMID: 8808210 DOI: 10.1093/ndt/10.12.2192] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [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: 02/02/2023] Open
Abstract
DOCA-NaCl treatment causes hypertension, accelerates development of proteinuria, and leads to glomerulosclerosis in rats with autoimmune Heymann nephritis. To study the mechanisms of kidney injury induced by renal haemodynamic load in chronic nephritis, we studied by immunohistochemistry the local expression of various cytokines, growth factors and adhesion molecules in the kidneys of Heymann nephritic rats with or without DOCA-NaCl-induced hypertension. The DOCA-NaCl-nephritis group developed hypertension and marked renal enlargement as compared with the nephritis group, the DOCA-NaCl group, and the controls. Albuminuria appeared earlier and was heavier in the DOCA-NaCl-nephritis group compared with the nephritic rats without DOCA-NaCl. Expression of IL-6, TNF-alpha, GM-CSF, b-FGF, NGF, TGF-beta, and ICAM-1 was enhanced in the kidneys of the DOCA-NaCl-nephritis group as compared with other groups, localized mainly in the glomerular mesangium (IL-6, GM-CSF, TGF-beta), glomerular and peritubular endothelium (ICAM-1), and collecting ducts (TNF-alpha, b-FGF, NGF, TGF-beta), possibly associated with the observed tubulointerstitial mononuclear cellular infiltration. Thus in autoimmune Heymann nephritis, DOCA-NaCl treatment causes hypertension and increased renal mass together with upregulation of local cytokine and growth factor production, which may further aggravate hypertension and accelerate progression of renal damage.
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Affiliation(s)
- I Tikkanen
- Minerva Institute for Medical Research, Helsinki University Central Hospital, Finland
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17
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Tikkanen T, Laasonen L, Tikkanen I. [Diagnosis and therapy of renovascular hypertension]. Duodecim 1995; 111:1453-60. [PMID: 9244701] [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: 02/04/2023]
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18
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Soininen K, Gerlin-Piira L, Suihkonen J, Kyllönen T, Parviainen R, Kyllönen E, Hämäläinen K, Lonka R, Tikkanen T, Selonen R. A study of the effects of lisinopril when used in addition to atenolol. J Hum Hypertens 1992; 6:321-4. [PMID: 1331443] [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: 12/26/2022]
Abstract
A double-blind, parallel group multicentre study was carried out to compare the effects of adding once daily treatment with lisinopril 10 or 20 mg and placebo to the treatment of 100 patients whose blood pressure was inadequately controlled with once daily atenolol 50 mg. Following a two-week run-in period, patients with a lying DBP between 95 mmHg and 115 mmHg were randomised to either lisinopril 10 mg or placebo once daily for four weeks. Blood pressure measurements were made approximately 24 h after the previous dose of study medication. After four weeks' treatment the dose of study medication was doubled for those patients whose lying DBP was greater than or equal to 90 mmHg and a final assessment was made after a further two weeks of treatment. Overall, six weeks' treatment with lisinopril produced a greater fall in lying blood pressures than placebo when added to atenolol therapy. The difference in favour of the additional ACE inhibitor therapy was 7.1 +/- 2.6/5.4 +/- 1.5 mmHg (mean +/- SEM) (P less than 0.01). Standing blood pressures showed similar behaviour in favour of the additional ACE inhibitor treatment (7.6 +/- 2.4/4.7 +/- 1.6 mmHg) (P less than 0.005). Heart rate was not altered significantly by either lisinopril or placebo treatment. The addition of lisinopril to treatment with atenolol produced a slight increase in the reported number of adverse events compared with placebo. The results of this study indicate that the addition of lisinopril 10-20 mg once daily to treatment with a beta-adrenoceptor blocking drug produces a worthwhile decrease in blood pressure in patients not responsive to beta-blocker therapy alone.
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Affiliation(s)
- K Soininen
- Etelä-Saimaa Central Hospital, Lappeenranta, Finland
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19
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Helin K, Tikkanen I, Tikkanen T, Saijonmaa O, Sybertz EJ, Vemulapalli S, Sariola H, Fyhrquist F. Prolonged neutral endopeptidase inhibition in heart failure. Eur J Pharmacol 1991; 198:23-30. [PMID: 1655477 DOI: 10.1016/0014-2999(91)90557-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [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: 12/28/2022]
Abstract
We studied the hormonal, renal and hemodynamic effects of prolonged treatment with SCH 39370, a new neutral endopeptidase (NEP) inhibitor, in experimental congestive heart failure (CHF). Coronary-ligated CHF rats and sham-operated controls received vehicle or SCH 39370 30 mg/kg s.c. twice daily for six days. In rats with heart failure, SCH 39370 elevated the high plasma atrial natriuretic peptide (ANP) and cyclic guanosine monophosphate (cGMP) levels 2-fold both initially and at the end of the experiment. Initially, water balance was more negative in SCH 39370-treated CHF rats than in those treated with vehicle. In all SCH 39370-treated rats, ANP, cGMP and electrolyte excretion and diuresis were pronounced for 6 h after injection but attenuated thereafter. Blood pressure and pulse remained unchanged. On reverse phase high performance liquid chromatography (HPLC), ANP-(99-126) appeared to be the only circulating form of ANP in rats with heart failure. Three forms have been discovered in patients with heart failure. HPLC revealed only intact ANP in plasma of rats with heart failure during SCH 39370 treatment. NEP inhibitors may provide a new tool for treating chronic heart failure.
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Affiliation(s)
- K Helin
- Minerva Institute for Medical Research, Helsinki, Finland
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20
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Tikkanen I, Helin K, Tikkanen T, Sybertz EJ, Vemulapalli S, Sariola H, Näveri H, Fyhrquist F. Elevation of plasma atrial natriuretic peptide in rats with chronic heart failure by SCH 39370, a neutral metalloendopeptidase inhibitor. J Pharmacol Exp Ther 1990; 254:641-5. [PMID: 2143536] [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: 12/30/2022] Open
Abstract
Hormonal, renal and blood pressure effects of SCH 39370, a selective inhibitor of neutral metalloendopeptidase (endopeptidase 24.11, NEP), were studied in a chronic, congestive heart failure (CHF) model produced by coronary artery ligation in the rat. Sham-operated control rats and rats with CHF were treated either with vehicle or SCH 39370, 30 mg/kg s.c. b.i.d. for 2.5 days. Plasma levels of atrial natriuretic peptide (ANP) and urinary excretion of cyclic GMP (cGMP) were clearly raised in rats with CHF as compared with controls during vehicle treatment. SCH 39370 caused a further increase in plasma ANP in CHF rats but not in control rats. Urinary excretion of immunoreactive ANP and cGMP increased during SCH 39370 treatment both in CHF rats and in controls. SCH 39370 treatment resulted in an initial increase in urine volume in rats with CHF whereas urine sodium excretion did not change significantly. No changes in renal function due to SCH 39370 treatment were seen in control rats. Systolic blood pressure, plasma renin activity and urine excretion of catecholamine metabolites (4-hydroxy-3-methoxyphenyl acetic acid and metanephrines) did not change during SCH 39370 treatment either in controls or in CHF rats. We conclude that the NEP-inhibitory compound SCH 39370 is capable of increasing plasma ANP concentration and urinary excretion of cGMP in rats with chronic CHF. In this severe heart failure model, the possible beneficial effects of additional ANP increments may be blunted, however. NEP inhibitors offer a novel approach to study the significance of ANP elevation in chronic CHF.
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Affiliation(s)
- I Tikkanen
- Minervera Institute for Medical Research, Helsinki, Finland
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21
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Fyhrquist F, Saijonmaa O, Metsärinne K, Tikkanen I, Rosenlöf K, Tikkanen T. Raised plasma endothelin-I concentration following cold pressor test. Biochem Biophys Res Commun 1990; 169:217-21. [PMID: 2190553 DOI: 10.1016/0006-291x(90)91456-3] [Citation(s) in RCA: 123] [Impact Index Per Article: 3.6] [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: 12/30/2022]
Abstract
Plasma concentration of immunoreactive endothelin-1 was measured by radioimmunoassay in 6 healthy subjects before and following cold pressor test by immersion of one fore-arm into ice-water. Mean (SEM) plasma endothelin-1 concentration rose from 1.2 (0.7) to peak value 8.4 (2.3) pg/ml in venous plasma from the immersed hand, and, reaching peak 2 minutes later, from 1.4 (0.5) to 4.6 (2.3) pg/ml in venous plasma from the contralateral hand. In 66 healthy control subjects, venous plasma concentration of endothelin-1 was 2.9 +/- 1.2 pg/ml (mean +/- SD). Exposure to cold is associated with raised blood levels of endothelin-1, which points to a relation between endothelin-1 and vasoconstriction associated with low temperature.
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Affiliation(s)
- F Fyhrquist
- Unit of Clinical Physiology, Minerva Institute for Medical Research, Helsinki, Finland
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22
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Tikkanen T, Raatikainen O, Tuomisto L. Calcium-dependent histidine and histamine release from superfused synaptosomes. Agents Actions 1990; 30:220-2. [PMID: 1695444 DOI: 10.1007/bf01969043] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The release of radioactive histidine and histamine was studied in a superfusion system by using guinea pig synaptosomes which were preloaded with 3H-histidine. Depolarization by 50 mM K+ induced a simultaneous release of histidine and histamine. The stimulated release of both of these substances was diminished when calcium was removed. The calcium-dependency of histamine release, previously demonstrated in brain slices, was confirmed using synaptosomes. It was also demonstrated that potassium-induced histidine release from guinea pig synaptosomes under superfusion conditions is at least partially calcium-dependent.
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Affiliation(s)
- T Tikkanen
- Department of Pharmacology and Toxicology, University of Kuopio, Finland
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23
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Grönhagen-Riska C, von Willebrand E, Tikkanen T, Honkanen E, Miettinen A, Holthöfer H, Törnroth T. The effect of cyclosporin A on the interstitial mononuclear cell infiltration and the induction of Heymann's nephritis. Clin Exp Immunol 1990; 79:266-72. [PMID: 2311304 PMCID: PMC1534753 DOI: 10.1111/j.1365-2249.1990.tb05189.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [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: 12/31/2022] Open
Abstract
Heymann's nephritis was induced with brush-border (BB) antigen. Interstitial mononuclear cell infiltration was studied with cytological examinations of fine-needle aspiration biopsies (FNAB), and with immunoperoxidase stains of frozen sections with monoclonal antisera. The effect of cyclosporin A (CyA), 20 mg/kg when administered intraperitoneally for 8 days in association with both initial immunization, and with the booster 4 weeks later, on the interstitial leukocyte infiltration and on the development of membranous glomerulonephritis (MGN) and proteinuria were investigated. Another group of rats was immunized, but not given CyA. Experimental animals were killed in groups 3, 6 and 20 weeks after initial immunization. CyA inhibited significantly the initial interstitial lymphocyte and blast cell response at 3 weeks (FNAB), but did not inhibit the secondary response after the booster. The anti-BB titre reacted in a similar fashion. Immunoperoxidase stains indicated a clearly suppressed T suppressor/cytolytic (T s/c) cell response. Glomerular basement membrane (GBM) deposits of IgG developed more slowly and were more scarce in the CyA-treated rats, when compared with the untreated group. Only one out of 15 CyA treated rats developed C3 deposits in the GBM during the course of the study, and none developed proteinuria, when most untreated rats (10/17) had C3 deposits and were nephrotic at 20 weeks. Thus, CyA depressed the initial interstitial cellular response after immunization with BB antigen, and also inhibited the development of antibody response, C3 deposits and proteinuria of Heymann nephritis. These effects of CyA may be contributed to an inhibited amplification of the autoimmune response associated with interstitial damage and continuous release of autoantigen.
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Affiliation(s)
- C Grönhagen-Riska
- Minerva Institute for Medical Research, Fourth Department of Medicine, University of Helsinki, Finland
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Tikkanen T, Tikkanen I, Sariola H, Svartström-Fraser M, Fyhrquist F. Attenuated diuretic and natriuretic effects of atrial natriuretic peptide in rats with heart failure. Horm Metab Res 1989; 21:185-8. [PMID: 2526789 DOI: 10.1055/s-2007-1009187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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: 01/01/2023]
Abstract
Plasma levels of atrial natriuretic peptide (ANP) and renal responses to ANP were examined in rats with chronic cardiac failure produced by coronary artery ligation and in sham-operated controls. Plasma ANP levels were elevated in the rats with severe cardiac failure as compared with the controls (P less than 0.001). ANP injections at the doses of 1, 5, 25 and 50 micrograms/kg increased water and sodium excretion significantly at all but the lowest dose in the controls; only the two largest doses caused clear diuresis and natriuresis in the heart failure group. The diuretic and natriuretic effects of ANP were significantly weaker at the doses of 5 and 25 micrograms/kg in the rats with heart failure as compared with the controls. We conclude, that natriuretic and diuretic effects of ANP are attenuated in this chronic heart failure mode.
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Affiliation(s)
- T Tikkanen
- Unit of Clinical Physiology, Minerva Institute for Medical Research, Helsinki, Finland
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25
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Abstract
In order to study long term changes in plasma atrial natriuretic peptide (ANP) in chronic heart failure, plasma ANP levels were determined in rats after myocardial infarction due to coronary artery ligation and in sham-operated controls. In addition, effects of oral captopril treatment and sodium loading on plasma ANP were studied. In accordance with earlier reports plasma ANP paralleled both infarct size and signs of cardiac dysfunction. The highest plasma ANP levels were found in rats having over 45% of their left ventricle infarcted while rats with mild-to-moderate-size infarcts had only slightly elevated plasma ANP levels as compared with controls. These differences in plasma ANP levels between experimental and control groups remained remarkably stable during the three-month observation period. Plasma renin activity (PRA) was elevated in infarcted rats but no differences could be found between rats with varying infarct sizes. Captopril treatment decreased the high plasma ANP levels in rats with the largest infarcts, probably by unloading the failing heart. During increased sodium intake, plasma ANP levels increased in sham-operated controls but not in rats with heart failure. Thus, sodium loading, as compared with cardiac insufficiency, appears to be a weak stimulus for ANP release in rats. I conclude that plasma ANP is a sensitive marker, better than PRA, in long term follow-up of cardiac dysfunction.
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Affiliation(s)
- T Tikkanen
- Unit of Clinical Physiology, Minerva Institute for Medical Research, Helsinki, Finland
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Tikkanen T, Svartström-Fraser M, Tikkanen I, Sariola H, Fyhrquist F. Haemodynamic effects of atrial natriuretic peptide in rats with heart failure. Eur J Pharmacol 1987; 140:187-93. [PMID: 2959488 DOI: 10.1016/0014-2999(87)90804-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [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: 01/03/2023]
Abstract
Plasma atrial natriuretic peptide (ANP), a hormone secreted by the heart, is elevated in cardiac failure. In the aim to study the role of ANP in cardiac failure, the haemodynamic response to ANP was examined in rats with chronic heart failure produced by coronary artery ligation. Plasma ANP was clearly elevated in all infarcted rats before ANP injection as compared with controls. ANP lowered the blood pressure and impaired cardiac contractility, as measured by the maximal positive value of the first derivative of the pressure signal, in a dose-dependent manner. The blood pressure lowering effects of ANP were attenuated in rats with cardiac failure. We conclude that rats with experimentally induced heart infarct are partially resistant to the haemodynamic effects of ANP.
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Affiliation(s)
- T Tikkanen
- Unit of Clinical Physiology, Minerva Institute for Medical Research, Helsinki, Finland
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Abstract
The plasma concentration of atrial natriuretic peptide (ANP) in 16 healthy subjects on a free diet was 41 +/- 23 pg ml-1 (mean +/- SD) when upright and 58 +/- 27 pg ml-1 in the supine position (P less than 0.05), which confirms the concept that the supine position raises plasma ANP. Water immersion to the neck for 2 h caused a brisk diuresis, natriuresis and raised plasma ANP in 8 healthy subjects, suggesting that ANP is a mediator of diuresis and natriuresis during immersion. Dynamic exercise (50-200 W per 4 min) on a bicycle ergometer caused a gradual increase in plasma ANP in 6 healthy males, with a close correlation between the increases in plasma ANP and heart rate (r = 0.96). Thus, plasma ANP levels are increased in healthy subjects by stimuli causing an increased preload and possibly by tachycardia itself. Markedly raised plasma levels of ANP were found in patients with congestive heart failure, and upright posture caused a further rise of plasma ANP which correlated with the increase in heart rate (r = 0.87). High plasma ANP concentrations were also found in 25 patients with end-stage renal failure maintained on haemodialysis. When these patients were subdivided into those with concomitant heart failure and those with normal cardiac function, changes in plasma ANP correlated with predialysis weight gain and weight loss during dialysis, but only in patients without heart failure. In 9 infants treated by operative or pharmacological closure of persistent ductus arteriosus, high pre-treatment plasma ANP values were lowered by successful therapy, and plasma ANP correlated with the degree of left atrial distension.(ABSTRACT TRUNCATED AT 250 WORDS)
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Abstract
We measured atrial natriuretic peptide (ANP) plasma levels in rats with experimental heart failure caused by left coronary artery ligation. ANP levels were clearly higher in infarcted rats (409 +/- 59 pg/ml; mean +/- S.E.M.) than in sham-operated controls (39 +/- 6 pg/ml). Moreover, plasma ANP levels increased progressively with the severity of cardiac dysfunction and size of infarct. Increased release of ANP in post-infarction heart failure appears to be a meaningful compensatory response to control rising preload. Our results are in keeping with evidence from human studies showing increased plasma concentration of ANP in patients with congestive heart failure. This model is a useful tool to further explore the role of ANP in heart failure.
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Abstract
In order to assess the possible role of atrial natriuretic peptide (ANP) in the development of deoxycorticosterone (DOCA)-NaCl-induced hypertension, plasma immunoreactive ANP concentration was compared with sodium balance and blood pressure in NaCl- or DOCA-NaCl-treated rats. Both NaCl-and DOCA-NaCl-loading increased plasma ANP levels (to 86 +/- 8.1 and 105 +/- 12 pg ml-1 respectively; 47 +/- 6.7-60 +/- 4.6 pg ml-1 in controls), which were correlated to sodium intake and excretion. In DOCA-NaCl-treated rats, the highest ANP levels (105 +/- 12 pg ml-1) were found 4 weeks after the beginning of DOCA-NaCl treatments. Along with the development of DOCA-NaCl hypertension in 1-kidney-DOCA-NaCl-treated rats, however, plasma ANP concentration did not rise further. We conclude that secretion of ANP into the circulation is increased during DOCA-NaCl treatment. Elevated blood pressure does not stimulate ANP release in DOCA-NaCl-treated rats further.
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Abstract
Captopril (SQ 14225) had a clear antihypertensive effect in rat Heymann nephritis-DOCA-NaCl hypertension, a low renin model introduced recently, but was ineffective in 1-kidney-DOCA-NaCl hypertension although plasma renin activity (PRA) was suppressed similarly in both. Thus, the antihypertensive effect of captopril was independent of circulating renin. This result also suggests different pathogenetic mechanisms of hypertension in these two DOCA-NaCl models.
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