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Neumann J, Hesse C, Hofmann B, Gergs U. Zacopride stimulates 5-HT 4 serotonin receptors in the human atrium. Naunyn Schmiedebergs Arch Pharmacol 2024:10.1007/s00210-024-03051-5. [PMID: 38557827 DOI: 10.1007/s00210-024-03051-5] [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] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
Zacopride (4-amino-5-chloro-2-methoxy-N-(quinuclidin-3-yl)-benzamide) is a potent agonist in human 5-HT4 serotonin receptors in vitro and in the gastrointestinal tract. Zacopride was studied as an antiemetic drug and was intended to treat gastric diseases. Zacopride has been speculated to be useful as an antiarrhythmic agent in the human ventricle by inhibiting cardiac potassium channels. It is unknown whether zacopride is an agonist in human cardiac 5-HT4 serotonin receptors. We tested the hypothesis that zacopride stimulates human cardiac atrial 5-HT4 serotonin receptors. Zacopride increased the force of contraction and beating rate in isolated atrial preparations from mice with cardiac-specific overexpression of human 5-HT4 serotonin receptors (5-HT4-TG). However, it was inactive in wild-type mouse hearts (WT). Zacopride was as effective as serotonin in raising the force of contraction and beating rate in atrial preparations of 5-HT4-TG. Zacopride raised the force of contraction in human right atrial preparations (HAP) in the absence and presence of the phosphodiesterase III inhibitor cilostamide (1 µM). The positive inotropic effect of zacopride in HAP was attenuated by either 10 µM tropisetron or 1 µM GR125487, both of which are antagonists at 5-HT4 serotonin receptors. These data suggest that zacopride is also an agonist at 5-HT4 serotonin receptors in the human atrium.
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Affiliation(s)
- Joachim Neumann
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, D-06097, Halle (Saale), Germany.
| | - Christin Hesse
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, D-06097, Halle (Saale), Germany
| | - Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle, Ernst-Grube-Straße 40, D-06097, Halle (Saale), Germany
| | - Ulrich Gergs
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, D-06097, Halle (Saale), Germany
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Schwarz R, Hofmann B, Gergs U, Neumann J. Cantharidin and sodium fluoride attenuate the negative inotropic effects of carbachol in the isolated human atrium. Naunyn Schmiedebergs Arch Pharmacol 2024; 397:2183-2202. [PMID: 37801145 PMCID: PMC10933163 DOI: 10.1007/s00210-023-02747-4] [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] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/23/2023] [Indexed: 10/07/2023]
Abstract
Carbachol, an agonist at muscarinic receptors, exerts a negative inotropic effect in human atrium. Carbachol can activate protein phosphatases (PP1 or PP2A). We hypothesized that cantharidin or sodium fluoride, inhibitors of PP1 and PP2A, may attenuate a negative inotropic effect of carbachol. During bypass-surgery trabeculae carneae of human atrial preparations (HAP) were obtained. These trabeculae were mounted in organ baths and electrically stimulated (1 Hz). Force of contraction was measured under isometric conditions. For comparison, we studied isolated electrically stimulated left atrial preparations (LA) from mice. Cantharidin (100 µM) and sodium fluoride (3 mM) increased force of contraction in LA (n = 5-8, p < 0.05) by 113% ± 24.5% and by 100% ± 38.2% and in HAP (n = 13-15, p < 0.05) by 625% ± 169% and by 196% ± 23.5%, respectively. Carbachol (1 µM) alone exerted a rapid transient maximum negative inotropic effect in LA (n = 6) and HAP (n = 14) to 46.9% ± 3.63% and 19.4% ± 3.74%, respectively (p < 0.05). These negative inotropic effects were smaller in LA (n = 4-6) and HAP (n = 9-12) pretreated with 100 µM cantharidin and amounted to 58.0% ± 2.27% and 59.2% ± 6.19% or 3 mM sodium fluoride to 63.7% ± 9.84% and 46.3% ± 5.69%, (p < 0.05). We suggest that carbachol, at least in part, exerts a negative inotropic effect in the human atrium by stimulating the enzymatic activity of PP1 and/or PP2A.
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Affiliation(s)
- Rebecca Schwarz
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle, Halle (Saale), Germany
| | - Ulrich Gergs
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Joachim Neumann
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
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Neumann J, Hesse C, Hofmann B, Gergs U. Mosapride stimulates human 5-HT 4-serotonin receptors in the heart. Naunyn Schmiedebergs Arch Pharmacol 2024:10.1007/s00210-024-03047-1. [PMID: 38498060 DOI: 10.1007/s00210-024-03047-1] [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] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/09/2024] [Indexed: 03/19/2024]
Abstract
Mosapride (4-amino-5-chloro-2-ethoxy-N-[[4-[(4-fluorophenyl) methyl]-2-morpholinyl]-methyl] benzamide) is a potent agonist at gastrointestinal 5-HT4 receptors. Mosapride is an approved drug to treat several gastric diseases. We tested the hypothesis that mosapride also stimulates 5-HT4 receptors in the heart. Mosapride increased the force of contraction and beating rate in isolated atrial preparations from mice with cardiac overexpression of human 5-HT4-serotonin receptors (5-HT4-TG). However, it is inactive in wild-type mouse hearts (WT). Mosapride was less effective and potent than serotonin in raising the force of contraction or the beating rate in 5-HT4-TG. Only in the presence of cilostamide (1 μM), a phosphodiesterase III inhibitor, mosapride, and its primary metabolite time dependently raised the force of contraction under isometric conditions in isolated paced human right atrial preparations (HAP, obtained during open heart surgery). In HAP, mosapride (10 μM) reduced serotonin-induced increases in the force of contraction. Mosapride (10 µM) shifted the concentration-response curves to serotonin in HAP to the right. These data suggest that mosapride is a partial agonist at 5-HT4-serotonin receptors in HAP.
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Affiliation(s)
- Joachim Neumann
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, 06112, Halle (Saale), Germany.
| | - Christin Hesse
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, 06112, Halle (Saale), Germany
| | - Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle, Ernst-Grube-Straße 40, 06097, Halle (Saale), Germany
| | - Ulrich Gergs
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, 06112, Halle (Saale), Germany
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Neumann J, Hußler W, Hofmann B, Gergs U. Contractile Effects of Amphetamine, Pseudoephedrine, Nor-pseudoephedrine (Cathine), and Cathinone on Atrial Preparations of Mice and Humans. J Cardiovasc Pharmacol 2024; 83:243-250. [PMID: 38181215 DOI: 10.1097/fjc.0000000000001536] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/11/2023] [Indexed: 01/07/2024]
Abstract
ABSTRACT Amphetamine derivatives are used worldwide legally or illegally and intoxications may be accompanied by cardiac arrhythmias. Here, we tested contractile effects of cumulative applied (±)-amphetamine, pseudoephedrine, nor-pseudoephedrine (cathine), and cathinone in electrically stimulated (1 Hz) human right atrial preparations (HAP) and mouse left atrial preparations and in spontaneously beating mouse right atrial preparations. In mouse atrial preparations, amphetamine increased force of contraction and beating rate in a concentration- and time-dependent manner, starting at 1 µM in left atrial preparations to 157.1% ± 3.0% and right atrial preparations to 146.6% ± 9.8% at 10 µM, respectively [mean ± standard error of the mean (SEM); n = 5; P < 0.05]. Pseudoephedrine, cathine, or cathinone alone were ineffective in mouse atrial preparations but after pre-incubation with the phosphodiesterase IV inhibitor rolipram (0.1 µM), a positive inotropic effect was noted (mean ± SEM: pseudoephedrine: 112.3% ± 9.8%; cathine: 109.0% ± 4.3%; cathinone: 138.3% ± 21.2%). The effects of all drugs were greatly attenuated by 10 µM cocaine or 10 µM propranolol treatments. However, In HAP, not only amphetamine (to a mean ± SEM of 208% ± 32%) but also pseudoephedrine (to a mean ± SEM of 287% ± 60%), cathine (to a mean ± SEM of 234% ± 52%), and cathinone (to a mean ± SEM of 217% ± 65%) increased force of contraction without the need of phosphodiesterase inhibition. The contractile effects in HAP were attenuated by 10 µM cocaine and antagonized by 10 µM propranolol. We conclude that amphetamine, pseudoephedrine, cathine, and cathinone act probably via release of noradrenaline from cardiac stores as indirect sympathomimetic agents in mouse and more pronounced in human atrial preparations.
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Affiliation(s)
- Joachim Neumann
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle, Germany; and
| | - Wilhelm Hußler
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle, Germany; and
| | - Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle, Halle, Germany
| | - Ulrich Gergs
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle, Germany; and
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Neumann J, Dhein S, Kirchhefer U, Hofmann B, Gergs U. Effects of congeners of amphetamine on the human heart. Naunyn Schmiedebergs Arch Pharmacol 2024:10.1007/s00210-024-02983-2. [PMID: 38340182 DOI: 10.1007/s00210-024-02983-2] [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] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/28/2024] [Indexed: 02/12/2024]
Abstract
Central stimulatory and hallucinogenic drugs of abuse like amphetamine and most congeners of amphetamine can have cardiac harmful effects. These cardiac side effects can lead to morbidities and death. In this paper, we review current knowledge on the direct and indirect effects of these amphetamine congeners on the mammalian heart-more specifically, the isolated human heart muscle preparation. In detail, we address the question of whether and how these drugs affect cardiac contractility and their mechanisms of action. Based on this information, further research areas are defined, and further research efforts are proposed.
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Affiliation(s)
- Joachim Neumann
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 4, 06112, D-06097, Halle, Germany.
| | - Stefan Dhein
- Rudolf-Boehm Institut für Pharmakologie und Toxikologie, Universität Leipzig, Härtelstraße 16-18, D-04107, Leipzig, Germany
| | | | - Britt Hofmann
- Cardiac Surgery, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany
| | - Ulrich Gergs
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 4, 06112, D-06097, Halle, Germany
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Neumann J, Dhein S, Kirchhefer U, Hofmann B, Gergs U. Effects of hallucinogenic drugs on the human heart. Front Pharmacol 2024; 15:1334218. [PMID: 38370480 PMCID: PMC10869618 DOI: 10.3389/fphar.2024.1334218] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/10/2024] [Indexed: 02/20/2024] Open
Abstract
Hallucinogenic drugs are used because they have effects on the central nervous system. Their hallucinogenic effects probably occur via stimulation of serotonin receptors, namely, 5-HT2A-serotonin receptors in the brain. However, a close study reveals that they also act on the heart, possibly increasing the force of contraction and beating rate and may lead to arrhythmias. Here, we will review the inotropic and chronotropic actions of bufotenin, psilocin, psilocybin, lysergic acid diethylamide (LSD), ergotamine, ergometrine, N,N-dimethyltryptamine, and 5-methoxy-N,N-dimethyltryptamine in the human heart.
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Affiliation(s)
- Joachim Neumann
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Stefan Dhein
- Rudolf-Boehm Institut für Pharmakologie und Toxikologie, Universität Leipzig, Leipzig, Germany
| | - Uwe Kirchhefer
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Universität Münster, Münster, Germany
| | - Britt Hofmann
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Ulrich Gergs
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
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Abella LMR, Jacob H, Hesse C, Hofmann B, Schneider S, Schindler L, Keller M, Buchwalow IB, Jin C, Panula P, Dhein S, Klimas J, Hadova K, Gergs U, Neumann J. Initial characterization of a transgenic mouse with overexpression of the human D 1-dopamine receptor in the heart. Naunyn Schmiedebergs Arch Pharmacol 2024:10.1007/s00210-023-02901-y. [PMID: 38177456 DOI: 10.1007/s00210-023-02901-y] [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] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 12/10/2023] [Indexed: 01/06/2024]
Abstract
Dopamine can exert effects in the mammalian heart via five different dopamine receptors. There is controversy whether dopamine receptors increase contractility in the human heart. Therefore, we have generated mice that overexpress the human D1-dopamine receptor in the heart (D1-TG) and hypothesized that dopamine increases force of contraction and beating rate compared to wild-type mice (WT). In D1-TG hearts, we ascertained the presence of D1-dopamine receptors by autoradiography using [3H]SKF 38393. The mRNA for human D1-dopamine receptors was present in D1-TG hearts and absent in WT. We detected by in-situ-hybridization mRNA for D1-dopamine receptors in atrial and ventricular D1-TG cardiomyocytes compared to WT but also in human atrial preparations. We noted that in the presence of 10 µM propranolol (to antagonize β-adrenoceptors), dopamine alone and the D1- and D5-dopamine receptor agonist SKF 38393 (0.1-10 µM cumulatively applied) exerted concentration- and time-dependent positive inotropic effects and positive chronotropic effects in left or right atrial preparations from D1-TG. The positive inotropic effects of SKF 38393 in left atrial preparations from D1-TG led to an increased rate of relaxation and accompanied by and probably caused by an augmented phosphorylation state of the inhibitory subunit of troponin. In the presence of 0.4 µM propranolol, 1 µM dopamine could increase left ventricular force of contraction in isolated perfused hearts from D1-TG. In this model, we have demonstrated a positive inotropic and chronotropic effect of dopamine. Thus, in principle, the human D1-dopamine receptor can couple to contractility in the mammalian heart.
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Affiliation(s)
- Lina Maria Rayo Abella
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, D-06097, Halle (Saale), Germany
| | - Hannes Jacob
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, D-06097, Halle (Saale), Germany
| | - Christin Hesse
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, D-06097, Halle (Saale), Germany
| | - Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle, D-06097, Halle (Saale), Germany
| | - Sarah Schneider
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, D-06097, Halle (Saale), Germany
| | - Lisa Schindler
- Institute of Pharmacy, University of Regensburg, D-93053, Regensburg, Germany
| | - Max Keller
- Institute of Pharmacy, University of Regensburg, D-93053, Regensburg, Germany
| | - Igor B Buchwalow
- Institute for Hematopathology, D-22547, Hamburg, Germany
- Scientific and Educational Resource Center for Molecular Morphology, Peoples' Friendship University of Russia, RU-117198, Moscow, Russia
| | - CongYu Jin
- Department of Anatomy, University of Helsinki, FI-00290, Helsinki, Finland
| | - Pertti Panula
- Department of Anatomy, University of Helsinki, FI-00290, Helsinki, Finland
| | - Stefan Dhein
- Rudolf-Boehm Institute for Pharmacology and Toxicology, University Leipzig, D-04107, Leipzig, Germany
| | - Jan Klimas
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, SK-83232, Bratislava, Slovak Republic
| | - Katarína Hadova
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, SK-83232, Bratislava, Slovak Republic
| | - Ulrich Gergs
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, D-06097, Halle (Saale), Germany
| | - Joachim Neumann
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, D-06097, Halle (Saale), Germany.
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Neumann J, Pockes S, Humphrys LJ, Mönnich D, Forster L, Kirchhefer U, Hofmann B, Gergs U. Clonidine stimulates force of contraction via histamine H 2 receptors in the human atrium. Naunyn Schmiedebergs Arch Pharmacol 2024; 397:617-626. [PMID: 37490122 PMCID: PMC10771369 DOI: 10.1007/s00210-023-02635-x] [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] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/17/2023] [Indexed: 07/26/2023]
Abstract
Clonidine has various clinical effects mediated by agonism of α1- or α2-adrenoceptors and the blocking of hyperpolarization-activated-nucleotide-gated pacemaker channels (HCN). It is unknown whether clonidine can also stimulate human cardiac histamine H2 receptors (hH2Rs). We used isolated electrically stimulated left and spontaneously beating right atrial preparations from mice overexpressing the hH2R specifically in the heart (H2-TG), and spontaneously beating right atrial preparations of guinea pigs for comparison. Moreover, we studied isolated electrically stimulated muscle strips from the human right atrium. Clonidine (1, 3, and 10 µM) increased force of contraction in isolated left atrial preparations from H2-TG mice. In contrast, clonidine reduced the spontaneous beating rate in right atrial preparations from H2-TG. Clonidine raised the beating rate in guinea pig right atrial preparations. Clonidine failed to increase the force of contraction but reduced beating rate in wild-type litter mate mice (WT). In WT, histamine failed to increase the force of contraction in left atrial preparations and beating rate in right atrial preparations. Clonidine (10 µM) increased the force of contraction in isolated human right atrial preparations. The positive inotropic effect in the human atrium was attenuated by cimetidine (10 µM). Clonidine increased the beating rate of the isolated spontaneously beating guinea pig right atrium and acted as a H2R partial agonist. Furthermore, clonidine showed binding to the guinea pig H2R (100 µM) using HEK cells in a recombinant expression system (pKi < 4.5) but hardly to the human H2R. These data suggest that clonidine can functionally activate cardiac human H2R.
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Affiliation(s)
- Joachim Neumann
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 4, D-06097, Halle (Saale), Germany.
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 4, D-06112, Halle (Saale), Germany.
| | - Steffen Pockes
- Institute of Pharmacy, University of Regensburg, Universitätsstraße 31, D-93040, Regensburg, Germany
| | - Laura J Humphrys
- Institute of Pharmacy, University of Regensburg, Universitätsstraße 31, D-93040, Regensburg, Germany
| | - Denise Mönnich
- Institute of Pharmacy, University of Regensburg, Universitätsstraße 31, D-93040, Regensburg, Germany
| | - Lisa Forster
- Institute of Pharmacy, University of Regensburg, Universitätsstraße 31, D-93040, Regensburg, Germany
| | - Uwe Kirchhefer
- Institute for Pharmacology and Toxicology, University Hospital Münster, Westfälische Wilhelms-University, Domagkstraße 12, D-48149, Münster, Germany
| | - Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle, Ernst Grube Straße 40, D-06097, Halle (Saale), Germany
| | - Ulrich Gergs
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 4, D-06097, Halle (Saale), Germany
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Gergs U, Jacob H, Braekow P, Hofmann B, Pockes S, Humphrys LJ, Kirchhefer U, Fehse C, Neumann J. Lysergic acid diethylamide stimulates cardiac human H 2 histamine and cardiac human 5-HT 4-serotonin receptors. Naunyn Schmiedebergs Arch Pharmacol 2024; 397:221-236. [PMID: 37401967 PMCID: PMC10771359 DOI: 10.1007/s00210-023-02591-6] [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] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 06/19/2023] [Indexed: 07/05/2023]
Abstract
Lysergic acid diethylamide (LSD) is an artificial hallucinogenic drug. Thus, we hypothesized that LSD might act 5-HT4 serotonin receptors and/or H2 histamine receptors. We studied isolated electrically stimulated left atrial preparations, spontaneously beating right atrial preparations, and spontaneously beating Langendorff-perfused hearts from transgenic mice with cardiomyocyte-specific overexpression of the human 5-HT4 receptor (5-HT4-TG) or of the H2-histamine receptor (H2-TG). For comparison, we used wild type littermate mice (WT). Finally, we measured isometric force of contraction in isolated electrically stimulated muscle strips from the human right atrium obtained from patients during bypass surgery. LSD (up to 10 µM) concentration dependently increased force of contraction and beating rate in left or right atrial preparations from 5-HT4-TG (n = 6, p < 0.05) in 5-HT4-TG atrial preparations. The inotropic and chronotropic effects of LSD were antagonized by 10 µM tropisetron in 5-HT4-TG. In contrast, LSD (10 µM) increased force of contraction and beating rate in left or right atrial preparations, from H2-TG. After pre-stimulation with cilostamide (1 µM), LSD (10 µM) increased force of contraction in human atrial preparations (n = 6, p < 0.05). The contractile effects of LSD in human atrial preparations could be antagonized by 10 µM cimetidine and 1 µM GR 125487. LSD leads to H2-histamine receptor and 5-HT4-receptor mediated cardiac effects in humans.
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Affiliation(s)
- Ulrich Gergs
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, 06097, Halle (Saale), Germany
| | - Hannes Jacob
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, 06097, Halle (Saale), Germany
| | - Pauline Braekow
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, 06097, Halle (Saale), Germany
| | - Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle, Ernst Grube Straße 40, 06097, Halle (Saale), Germany
| | - Steffen Pockes
- Institute of Pharmacy, University of Regensburg, Universitätsstraße 31, 93040, Regensburg, Germany
| | - Laura J Humphrys
- Institute of Pharmacy, University of Regensburg, Universitätsstraße 31, 93040, Regensburg, Germany
| | - Uwe Kirchhefer
- Institute for Pharmacology and Toxicology, University Hospital Münster, Westfälische Wilhelms-University, Domagkstraße 12, 48149, Münster, Germany
| | - Charlotte Fehse
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, 06097, Halle (Saale), Germany
| | - Joachim Neumann
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, 06097, Halle (Saale), Germany.
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Hofmann B, Rae E, Puvogel U, Spatarelu M, Mohamed SA, Bungaran A, Arzt S, Laux ML, Matschke K, Feyrer R, Sievers HH, Friedrich I, Niemann B, Silber RE, Wienke A, Simm A. Living Longer or Better-Patient's Choice in Cardiac Surgery Is Gender-Dependent-A Multicenter Study. J Clin Med 2023; 12:7596. [PMID: 38137666 PMCID: PMC10743955 DOI: 10.3390/jcm12247596] [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: 07/28/2023] [Revised: 11/08/2023] [Accepted: 11/26/2023] [Indexed: 12/24/2023] Open
Abstract
In view of the increasing age of cardiac surgery patients, questions arise about the expected postoperative quality of life and the hoped-for prolonged life expectancy. Little is known so far about how these, respectively, are weighted by the patients concerned. This study aims to obtain information on the patients' preferences. Between 2015 and 2017, data were analyzed from 1349 consecutive patients undergoing cardiac surgery at seven heart centers in Germany. Baseline data regarding the patient's situation as well as a questionnaire regarding quality of life versus lifespan were taken preoperatively. Patients were divided by age into four groups: below 60, 60-70, 70-80, and above 80 years. As a result, when asked to decide between quality of life and length of life, about 60% of the male patients opted for quality of life, independent of their age. On the other hand, female patients' preference for quality of life increased significantly with age, from 51% in the group below sixty to 76% in the group above eighty years. This finding suggests that female patients adapt their preferences with age, whereas male patients do not. This should impact further the treatment decisions of elderly patients in cardiac surgery within a shared decision-making process.
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Affiliation(s)
- Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (B.H.)
| | - Epp Rae
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (B.H.)
| | - Ulrike Puvogel
- Department of Cardiac and Vascular Surgery, 35392 Gießen, Germany
| | | | - Salah A. Mohamed
- Department of Cardiac and Thoracic Surgery, 23538 Lübeck, Germany
| | | | | | - Magdalena L. Laux
- Department of Cardiovascular Surgery, Heart Center Brandenburg, University Hospital Brandenburg Medical School, Faculty of Health Sciences Brandenburg, 16321 Bernau, Germany
| | | | | | | | | | - Bernd Niemann
- Department of Cardiac and Vascular Surgery, 35392 Gießen, Germany
| | - Rolf-Edgar Silber
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (B.H.)
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Medical Faculty, Martin-Luther-University Halle-Wittenberg, 06112 Halle (Saale), Germany
| | - Andreas Simm
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (B.H.)
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Jacob H, Braekow P, Hofmann B, Kirchhefer U, Forster L, Mönnich D, Humphrys LJ, Pockes S, Neumann J, Gergs U. Ergometrine stimulates histamine H 2 receptors in the isolated human atrium. Naunyn Schmiedebergs Arch Pharmacol 2023; 396:3809-3822. [PMID: 37354215 PMCID: PMC10643397 DOI: 10.1007/s00210-023-02573-8] [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] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/11/2023] [Indexed: 06/26/2023]
Abstract
Ergometrine (6aR,9R)-N-((S)-1-hydroxypropan-2-yl)-7-methyl-4,6,6a,7,8,9-hexa-hydro-indolo-[4,3-fg]chinolin-9-carboxamide or lysergide acid β-ethanolamide or ergonovine) activates several types of serotonin and histamine receptors in the animal heart. We thus examined whether ergometrine can activate human serotonin 5-HT4 receptors (h5-HT4R) and/or human histamine H2 receptors (hH2R) in the heart of transgenic mice and/or in the human isolated atrium. Force of contraction or beating rates were studied in electrically stimulated left atrial or spontaneously beating right atrial preparations or spontaneously beating isolated retrogradely perfused hearts (Langendorff setup) of mice with cardiac specific overexpression of the h5-HT4R (5-HT4-TG) or of mice with cardiac specific overexpression of the hH2R (H2-TG) or in electrically stimulated human right atrial preparations obtained during cardiac surgery. Western blots to assess phospholamban (PLB) phosphorylation on serine 16 were performed. Ergometrine exerted concentration- and time-dependent positive inotropic effects and positive chronotropic effects in atrial preparations starting at 0.3 µM and reaching a plateau at 10 µM in H2-TGs (n = 7). This was accompanied by an increase in PLB phosphorylation at serine 16. Ergometrine up 10 µM failed to increase force of contraction in left atrial preparations from 5-HT4-TGs (n = 5). Ten micrometer ergometrine increased the force of contraction in isolated retrogradely perfused spontaneously beating heart preparations (Langendorff setup) from H2-TG but not 5-HT4-TG. In the presence of the phosphodiesterase inhibitor cilostamide (1 µM), ergometrine at 10 µM exerted positive inotropic effects in isolated electrically stimulated human right atrial preparations, obtained during cardiac surgery, and these effects were eliminated by 10 µM of the H2R antagonist cimetidine but not by 10 µM of the 5-HT4R antagonist tropisetron. Furthermore, ergometrine showed binding to human histamine H2 receptors (at 100 µM and 1 mM) using HEK cells in a recombinant expression system (pKi < 4.5, n = 3). In conclusion, we suggest that ergometrine is an agonist at cardiac human H2Rs.
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Affiliation(s)
- Hannes Jacob
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, 06097, Halle (Saale), Germany
| | - Pauline Braekow
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, 06097, Halle (Saale), Germany
| | - Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle, Ernst Grube Straße 40, 06097, Halle (Saale), Germany
| | - Uwe Kirchhefer
- Institute for Pharmacology and Toxicology, Medical Faculty, Westfälische Wilhelms- Universität Münster, Domagkstraße 12, 48149, Münster, Germany
| | - Lisa Forster
- Institute of Pharmacy, University of Regensburg, Universitätsstraße 31, 93040, Regensburg, Germany
| | - Denise Mönnich
- Institute of Pharmacy, University of Regensburg, Universitätsstraße 31, 93040, Regensburg, Germany
| | - Laura J Humphrys
- Institute of Pharmacy, University of Regensburg, Universitätsstraße 31, 93040, Regensburg, Germany
| | - Steffen Pockes
- Institute of Pharmacy, University of Regensburg, Universitätsstraße 31, 93040, Regensburg, Germany
| | - Joachim Neumann
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, 06097, Halle (Saale), Germany.
| | - Ulrich Gergs
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, 06097, Halle (Saale), Germany
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Refolo P, Sacchini D, Bloemen B, Grin J, Gutierrez-Ibarluzea I, Hofmann B, Oortwijn W, Raimondi C, Sampietro-Colom L, Sandman L, van der Wilt GJ, Spagnolo AG. On the normativity of evidence - Lessons from philosophy of science and the "VALIDATE" project. Eur Rev Med Pharmacol Sci 2023; 27:11202-11210. [PMID: 38095370 DOI: 10.26355/eurrev_202312_34560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
"Evidence" is a key term in medicine and health services research, including Health Technology Assessment (HTA). Randomized clinical trials (RCTs) have undoubtedly dominated the scene of generating evidence for a long period of time, becoming the hallmark of evidence-based medicine (EBM). However, due to a number of misunderstandings, the lay audience and some researchers have sometimes placed too much trust in RCTs compared to other methods of investigation. One of the principal misunderstandings is to consider RCTs findings as isolated and self-apparent pieces of information. In other words, what has been essentially lacking was the awareness of the value-context of the evidence and, in particular, the value- and theory-ladenness (normativity) of scientific knowledge. This paper aims to emphasize the normativity that exists in the production of scientific knowledge, and in particular in the conduct of RCTs as well as in the performance of HTA. The work is based on some lessons learned from Philosophy of Science and the European project "VALIDATE" (VALues In Doing Assessments of healthcare TEchnologies"). VALIDATE was a three-year EU Erasmus+ strategic partnerships project (2018-2021), in which training in the field of HTA was further optimized by using insights from political science and ethics (in accordance with the recent definition of HTA). Our analysis may reveal useful insights for addressing some challenges that HTA is going to face in the future.
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Affiliation(s)
- P Refolo
- Research Center for Clinical Bioethics and Medical Humanities, Università Cattolica del Sacro Cuore, Rome, Italy.
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Rayo-Abella LM, Grundig P, Bernhardt MN, Hofmann B, Neumann J, Gergs U. OR-1896 increases force of contraction in the isolated human atrium. Naunyn Schmiedebergs Arch Pharmacol 2023; 396:3823-3833. [PMID: 37354216 PMCID: PMC10643428 DOI: 10.1007/s00210-023-02592-5] [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] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/19/2023] [Indexed: 06/26/2023]
Abstract
OR-1896 ((R)-N-(4-(4-methyl-6-oxo-1,4,5,6-tetrahydropyridazin-3-yl)phenyl)acetamide) is the main active metabolite of levosimendan. However, nobody has reported a positive inotropic effect of OR-1896 in isolated human cardiac preparations. The mechanism of action of OR-1896 remains controversial. Hence, we wanted to know whether OR-1896 exerts a positive inotropic effect in humans and what might be the underlying mechanism. Therefore, we measured the contractile effects of OR-1896 (0.01-10 µM cumulatively applied) in isolated electrically stimulated (1 Hz) human right atrial preparations (HAP) obtained during cardiac surgery. OR-1896, given alone, exerted time- and concentration-dependent positive inotropic effects; 1-µM OR-1896 increased force by 72 ± 14.7% (p < 0.05, n = 6) and shortened the time of relaxation by 10.6 ± 3.6% (p < 0.05, n = 11) in HAP started at 0.1 µM, plateaued at 1-µM OR-1896, and was antagonized by 1-µM propranolol. The maximum positive inotropic effect of OR-1896 in human right atrial preparations was less than that of 10-µM isoprenaline. EMD 57033 (10 µM), a calcium sensitizer, enhanced the force of contraction further in the additional presence of 1-µM OR-1896 by 109 ± 19% (p < 0.05, n = 4). Cilostamide (10 µM), an inhibitor of phosphodiesterase III given before OR-1896 (1 µM), blocked the positive inotropic effect of OR-1896 in HAP. Our data suggest that OR-1896 is, indeed, a positive inotropic agent in the human heart. OR-1896 acts as a PDE III inhibitor. OR-1896 is unlikely to act as a calcium sensitizer in the human heart.
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Affiliation(s)
- Lina M Rayo-Abella
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Straße 4, 06097, Halle, Germany
| | - Peter Grundig
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Straße 4, 06097, Halle, Germany
| | - Max N Bernhardt
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Straße 4, 06097, Halle, Germany
| | - Britt Hofmann
- Herzchirurgie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Ernst Grube Straße 40, 06097, Halle, Germany
| | - Joachim Neumann
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Straße 4, 06097, Halle, Germany.
| | - Ulrich Gergs
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Straße 4, 06097, Halle, Germany
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Hofmann B. Image rejects in digital skeletal radiography in two public hospitals in Norway. Radiography (Lond) 2023; 29:1063-1067. [PMID: 37741144 DOI: 10.1016/j.radi.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/01/2023] [Accepted: 09/07/2023] [Indexed: 09/25/2023]
Abstract
INTRODUCTION The proportion of diagnostic images not applied for diagnostic purposes is an indicator of image quality, safety, and efficiency in radiography. Despite increased awareness, image reject is still a substantial problem and needs continued observation and targeted measures. Accordingly, the objective of this study is to estimate the extent, variation, and characteristics of image rejects, in order to improve the quality, safety, and efficiency in radiography. METHODS All skeletal images at two digital X-ray rooms at two public hospitals in Norway were reviewed for four weeks in 2020. The number of exposed images, type of examination, and number of deleted images were registered. For each deleted image the deduced reasons for deleting the image were recorded. RESULTS 2183 and 1467 X-ray images were taken at Hospital 1 and 2 respectively. The corresponding reject rates were 14.2% and 9.1%. The reject rate varied greatly from day to day (from 0% to 22%), and the examinations with the highest reject rate were X-ray of extremities (knee, elbow, ankle, wrist) (12-25%) and of the spine (14-19%). The two clearly dominating reasons for image rejects were positioning and centering errors. CONCLUSION The reject rate is high and reduces quality, safety, and efficiency of imaging services. The reasons for image rejects are typical professionally reducible errors indicating great potential for improvement. IMPLICATIONS FOR PRACTICE Monitoring and assessing image rejects are of great importance to management, training, education, patient safety, and for quality improvement of imaging services.
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Affiliation(s)
- B Hofmann
- Institute for the Health Sciences at the Norwegian University of Science and Technology (NTNU), Gjøvik, Norway; Centre of Medical Ethics at the University of Oslo, Norway.
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Schwarz R, Hofmann B, Gergs U, Neumann J. Cantharidin increases the force of contraction and protein phosphorylation in isolated human atria. Naunyn Schmiedebergs Arch Pharmacol 2023; 396:2613-2625. [PMID: 37097333 PMCID: PMC10497697 DOI: 10.1007/s00210-023-02483-9] [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] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/30/2023] [Indexed: 04/26/2023]
Abstract
Cantharidin, an inhibitor of protein phosphatase 1 (PP1) and protein phosphatase 2A (PP2A), is known to increase the force of contraction and shorten the time to relaxation in human ventricular preparations. We hypothesized that cantharidin has similar positive inotropic effects in human right atrial appendage (RAA) preparations. RAA were obtained during bypass surgery performed on human patients. These trabeculae were mounted in organ baths and electrically stimulated at 1 Hz. For comparison, we studied isolated electrically stimulated left atrial (LA) preparations and isolated spontaneously beating right atrial (RA) preparations from wild-type mice. Cumulatively applied (starting at 10 to 30 µM), cantharidin exerted a positive concentration-dependent inotropic effect that plateaued at 300 µM in the RAA, LA, and RA preparations. This positive inotropic effect was accompanied by a shortening of the time to relaxation in human atrial preparations (HAPs). Notably, cantharidin did not alter the beating rate in the RA preparations. Furthermore, cantharidin (100 µM) increased the phosphorylation state of phospholamban and the inhibitory subunit of troponin I in RAA preparations, which may account for the faster relaxation observed. The generated data indicate that PP1 and/or PP2A play a functional role in human atrial contractility.
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Affiliation(s)
- R. Schwarz
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, 06112 Halle (Saale), Germany
| | - B. Hofmann
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle, Halle (Saale), Germany
| | - U. Gergs
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, 06112 Halle (Saale), Germany
| | - J. Neumann
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, 06112 Halle (Saale), Germany
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Hoffmann RJR, Gergs U, Hofmann B, Kirchhefer U, Neumann J. Temperature alters the inotropic, chronotropic and proarrhythmic effects of histamine in atrial muscle preparations from humans and H 2-receptor overexpressing mice. Naunyn Schmiedebergs Arch Pharmacol 2023; 396:2137-2150. [PMID: 36951998 PMCID: PMC10409711 DOI: 10.1007/s00210-023-02457-x] [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] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/03/2023] [Indexed: 03/24/2023]
Abstract
We investigated whether hypothermia and hyperthermia can alter the efficacy and potency of histamine at increasing the force of cardiac contractions in mice that overexpress the human H2 receptor only in their cardiac myocytes (labelled H2-TG). Contractile studies were performed in an organ bath on isolated, electrically driven (1 Hz) left atrial preparations and spontaneously beating right atrial preparations from H2-TG mice and wild-type (WT) littermate control mice. The basal beating rate in the right atrial preparations from H2-TG mice was lowered by hypothermia (23 °C) and elevated by hyperthermia (42 °C). Furthermore, the efficacy of histamine (0.01-100 µM) at exerting positive inotropic effects was more severely attenuated in the left and right H2-TG mouse atria under hypothermia and hyperthermia than under normothermia (37 °C). Similarly, the inotropic response to histamine was attenuated under hypothermia and hyperthermia in isolated electrically stimulated (1 Hz) right atrial preparations obtained from humans undergoing cardiac surgery. The phosphorylation state of phospholamban at serine 16 at 23 °C was inferior to that at 37 °C in left atrial preparations from H2-TG mice in the presence of 10 µM histamine. In contrast, in human atrial preparations, the phosphorylation state of phospholamban at serine 16 in the presence of 100 µM histamine was lower at 42 °C than at 37 °C. Finally, under hyperthermia, we recorded more and longer lasting arrhythmias in right atrial preparations from H2-TG mice than in those from WT mice. We conclude that the inotropic effects of histamine in H2-TG mice and in human atrial preparations, as well as the chronotropic effects of histamine in H2-TG mice, are temperature dependent. Furthermore, we observed that, even without stimulation of the H2 receptors by exogenous agonists, temperature elevation can increase arrhythmias in isolated right atrial preparations from H2-TG mice. We propose that H2 receptors play a role in hyperthermia-induced supraventricular arrhythmias in human patients.
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Affiliation(s)
- Robert J. R. Hoffmann
- Institut Für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, 06097 Halle, Germany
| | - Ulrich Gergs
- Institut Für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, 06097 Halle, Germany
| | - Britt Hofmann
- Medizinische Fakultät, Herzchirurgie, Martin-Luther-Universität Halle-Wittenberg, 06097 Halle, Germany
| | - Uwe Kirchhefer
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Westfälische Wilhelms-Universität, Domagkstr. 12, 48149 Münster, Germany
| | - Joachim Neumann
- Institut Für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, 06097 Halle, Germany
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Saemann L, Wernstedt L, Pohl S, Stiller M, Willsch J, Hofmann B, Veres G, Simm A, Szabó G. Impact of Age on Endothelial Function of Saphenous Vein Grafts in Coronary Artery Bypass Grafting. J Clin Med 2023; 12:5454. [PMID: 37685521 PMCID: PMC10487541 DOI: 10.3390/jcm12175454] [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: 07/27/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND An intact and functionally preserved endothelial layer in the graft is crucial for myocardial perfusion and graft patency after coronary artery bypass grafting (CABG). We hypothesized that old age is a risk factor for decreased endothelial function of bypass grafts. Thus, we investigated the impact of age in patients treated with CABG on endothelial function in saphenous vein grafts. METHODS We mounted the saphenous vein graft segments of CABG patients < 70 (n = 33) and ≥70 (n = 40) years of age in organ bath chambers and exposed them to potassium chloride (KCl) and phenylephrine (PE) to test the receptor-independent and -dependent contractility, followed by exposure to acetylcholine (ACh) and sodium nitroprusside (SNP) to test the endothelial-dependent and -independent relaxation. RESULTS The maximal contraction induced by KCl (2.3 ± 1.8 vs. 1.8 ± 2 g) was stronger in patients ≥ 70 years of age. The relative contraction induced by PE in % of KCl (167 ± 64 vs. 163 ± 59%) was similar between groups. Patients aged < 70 years showed a higher endothelial-dependent relaxation induced by acetylcholine than patients ≥ 70 years (51 ± 27 vs. 42 ± 18%). The relaxation induced by SNP was similar between both groups. CONCLUSIONS The endothelial function of saphenous vein bypass grafts decreases during aging. Thus, age should be considered when improving graft maintenance.
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Affiliation(s)
- Lars Saemann
- Department of Cardiac Surgery, University Hospital Halle, Ernst-Grube-Straße 40, 06120 Halle (Saale), Germany (G.V.); (A.S.); (G.S.)
| | - Lena Wernstedt
- Department of Cardiac Surgery, University Hospital Halle, Ernst-Grube-Straße 40, 06120 Halle (Saale), Germany (G.V.); (A.S.); (G.S.)
| | - Sabine Pohl
- Department of Cardiac Surgery, University Hospital Halle, Ernst-Grube-Straße 40, 06120 Halle (Saale), Germany (G.V.); (A.S.); (G.S.)
| | - Markus Stiller
- Department of Cardiac Surgery, University Hospital Halle, Ernst-Grube-Straße 40, 06120 Halle (Saale), Germany (G.V.); (A.S.); (G.S.)
| | - Jan Willsch
- Department of Cardiac Surgery, University Hospital Halle, Ernst-Grube-Straße 40, 06120 Halle (Saale), Germany (G.V.); (A.S.); (G.S.)
| | - Britt Hofmann
- Department of Cardiac Surgery, University Hospital Halle, Ernst-Grube-Straße 40, 06120 Halle (Saale), Germany (G.V.); (A.S.); (G.S.)
| | - Gábor Veres
- Department of Cardiac Surgery, University Hospital Halle, Ernst-Grube-Straße 40, 06120 Halle (Saale), Germany (G.V.); (A.S.); (G.S.)
| | - Andreas Simm
- Department of Cardiac Surgery, University Hospital Halle, Ernst-Grube-Straße 40, 06120 Halle (Saale), Germany (G.V.); (A.S.); (G.S.)
| | - Gábor Szabó
- Department of Cardiac Surgery, University Hospital Halle, Ernst-Grube-Straße 40, 06120 Halle (Saale), Germany (G.V.); (A.S.); (G.S.)
- Department of Cardiac Surgery, Heidelberg University Hospital, 69120 Heidelberg, Germany
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Neumann J, Hofmann B, Dhein S, Gergs U. Glucagon and Its Receptors in the Mammalian Heart. Int J Mol Sci 2023; 24:12829. [PMID: 37629010 PMCID: PMC10454195 DOI: 10.3390/ijms241612829] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/25/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
Glucagon exerts effects on the mammalian heart. These effects include alterations in the force of contraction, beating rate, and changes in the cardiac conduction system axis. The cardiac effects of glucagon vary according to species, region, age, and concomitant disease. Depending on the species and region studied, the contractile effects of glucagon can be robust, modest, or even absent. Glucagon is detected in the mammalian heart and might act with an autocrine or paracrine effect on the cardiac glucagon receptors. The glucagon levels in the blood and glucagon receptor levels in the heart can change with disease or simultaneous drug application. Glucagon might signal via the glucagon receptors but, albeit less potently, glucagon might also signal via glucagon-like-peptide-1-receptors (GLP1-receptors). Glucagon receptors signal in a species- and region-dependent fashion. Small molecules or antibodies act as antagonists to glucagon receptors, which may become an additional treatment option for diabetes mellitus. Hence, a novel review of the role of glucagon and the glucagon receptors in the mammalian heart, with an eye on the mouse and human heart, appears relevant. Mouse hearts are addressed here because they can be easily genetically modified to generate mice that may serve as models for better studying the human glucagon receptor.
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Affiliation(s)
- Joachim Neumann
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, D-06097 Halle (Saale), Germany;
| | - Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle, Ernst Grube Straße 40, D-06097 Halle (Saale), Germany;
| | - Stefan Dhein
- Rudolf-Boehm Institut für Pharmakologie und Toxikologie, Universität Leipzig, Härtelstraße 16-18, D-04107 Leipzig, Germany;
| | - Ulrich Gergs
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 4, D-06097 Halle (Saale), Germany;
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Schulz S, Rehm S, Schlitt A, Lierath M, Lüdike H, Hofmann B, Bitter K, Reichert S. C-Reactive Protein Level and the Genetic Variant rs1130864 in the CRP Gene as Prognostic Factors for 10-Year Cardiovascular Outcome. Cells 2023; 12:1775. [PMID: 37443809 PMCID: PMC10341152 DOI: 10.3390/cells12131775] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 06/12/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the primary cause of premature death and disability worldwide. There is extensive evidence that inflammation represents an important pathogenetic mechanism in the development and prognosis of CVD. C-reactive protein (CRP) is a potential marker of vascular inflammation and plays a direct role in CVD by promoting vascular inflammation. The objective of this study (ClinTrials.gov identifier: NCT01045070) was to assess the prognostic impact of CRP protein levels and genetic variants of CRP gene events on cardiovascular (CV) outcome (10-year follow-up) in patients suffering from CVD. METHODS CVD patients were prospectively included in this study (n = 1002) and followed up (10 years) regarding combined CV endpoint (CV death, death from stroke, myocardial infarction (MI), and stroke/transient ischemic attack (TIA)). CRP protein level (particle-enhanced immunological turbidity test) and genetic variants (rs1130864, rs1417938, rs1800947, rs3093077; polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) after DNA extraction from EDTA-blood) were evaluated. RESULTS In survival analyses, increased CRP protein levels of ≥5 mg/L (log-rank test: p < 0.001, Cox regression: p = 0.002, hazard ratio = 1.49) and CT + TT genotype of rs1130864 (log-rank test: p = 0.041; Cox regression: p = 0.103, hazard ratio = 1.21) were associated with a weaker CV prognosis considering combined CV endpoint. CONCLUSIONS Elevated CRP level and genetic variant (rs1130864) were proven to provide prognostic value for adverse outcome in CVD patients within the 10-year follow-up period.
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Affiliation(s)
- Susanne Schulz
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany; (S.R.); (M.L.); (H.L.); (K.B.); (S.R.)
| | - Selina Rehm
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany; (S.R.); (M.L.); (H.L.); (K.B.); (S.R.)
| | - Axel Schlitt
- Department of Cardiology, Paracelsus-Harz-Clinic Bad Suderode, 06485 Quedlinburg, Germany;
- Department of Medicine III, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany
| | - Madlen Lierath
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany; (S.R.); (M.L.); (H.L.); (K.B.); (S.R.)
| | - Henriette Lüdike
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany; (S.R.); (M.L.); (H.L.); (K.B.); (S.R.)
| | - Britt Hofmann
- Department of Cardiothoracic Surgery, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany;
| | - Kerstin Bitter
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany; (S.R.); (M.L.); (H.L.); (K.B.); (S.R.)
| | - Stefan Reichert
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany; (S.R.); (M.L.); (H.L.); (K.B.); (S.R.)
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Neumann J, Hußler W, Azatsian K, Hofmann B, Gergs U. Methamphetamine increases force of contraction in isolated human atrial preparations through the release of noradrenaline. Toxicol Lett 2023:S0378-4274(23)00212-6. [PMID: 37394154 DOI: 10.1016/j.toxlet.2023.06.012] [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: 03/29/2023] [Revised: 06/09/2023] [Accepted: 06/29/2023] [Indexed: 07/04/2023]
Abstract
We measured the cardiac contractile effects of the sympathomimetic amphetamine-like drug methamphetamine alone and in the presence of cocaine or propranolol in human atrial preparations. For a more comprehensive analysis, we also examined the effects of methamphetamine in preparations from the left and right atria of mice and, for comparison, analyzed the cardiac effects of amphetamine itself. In human atrial preparations, methamphetamine and amphetamine increased the contractile force, the relaxation rate, and the rate of tension development, and shortened the time to maximum tension and the time to relaxation. Likewise, in mice preparations, methamphetamine and amphetamine increased the contractile force in the left atrium and increased the beating rate in the right atrium. The effect in human atrial preparations started at 1µM, therefore methamphetamine was less effective and potent than isoproterenol in increasing contractile force. These positive inotropic effects of methamphetamine were greatly attenuated by 10µM cocaine and abolished by 10µM propranolol. The inotropic effects of methamphetamine in human atrial preparations were associated with, and are believed to be mediated at least in part by, an increase in the phosphorylation state of the inhibitory subunit of troponin. In conclusion, the sympathomimetic central stimulant drug methamphetamine (as well as amphetamine) increased contractile force and protein phosphorylation, presumably through a release of noradrenaline in isolated human atrial preparations. Thus, methamphetamine acts as an indirect sympathomimetic in the human atrium.
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Affiliation(s)
- Joachim Neumann
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, D-06097 Halle, Germany
| | - Wilhelm Hußler
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, D-06097 Halle, Germany
| | - Karyna Azatsian
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, D-06097 Halle, Germany
| | - Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle, D-06097 Halle, Germany
| | - Ulrich Gergs
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, D-06097 Halle, Germany.
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Neumann J, Hofmann B, Kirchhefer U, Dhein S, Gergs U. Function and Role of Histamine H 1 Receptor in the Mammalian Heart. Pharmaceuticals (Basel) 2023; 16:ph16050734. [PMID: 37242517 DOI: 10.3390/ph16050734] [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: 03/27/2023] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Histamine can change the force of cardiac contraction and alter the beating rate in mammals, including humans. However, striking species and regional differences have been observed. Depending on the species and the cardiac region (atrium versus ventricle) studied, the contractile, chronotropic, dromotropic, and bathmotropic effects of histamine vary. Histamine is present and is produced in the mammalian heart. Thus, histamine may exert autocrine or paracrine effects in the mammalian heart. Histamine uses at least four heptahelical receptors: H1, H2, H3 and H4. Depending on the species and region studied, cardiomyocytes express only histamine H1 or only histamine H2 receptors or both. These receptors are not necessarily functional concerning contractility. We have considerable knowledge of the cardiac expression and function of histamine H2 receptors. In contrast, we have a poor understanding of the cardiac role of the histamine H1 receptor. Therefore, we address the structure, signal transduction, and expressional regulation of the histamine H1 receptor with an eye on its cardiac role. We point out signal transduction and the role of the histamine H1 receptor in various animal species. This review aims to identify gaps in our knowledge of cardiac histamine H1 receptors. We highlight where the published research shows disagreements and requires a new approach. Moreover, we show that diseases alter the expression and functional effects of histamine H1 receptors in the heart. We found that antidepressive drugs and neuroleptic drugs might act as antagonists of cardiac histamine H1 receptors, and believe that histamine H1 receptors in the heart might be attractive targets for drug therapy. The authors believe that a better understanding of the role of histamine H1 receptors in the human heart might be clinically relevant for improving drug therapy.
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Affiliation(s)
- Joachim Neumann
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Magdeburger Straße 4, Martin-Luther-Universität Halle-Wittenberg, 06097 Halle, Germany
| | - Britt Hofmann
- Herzchirurgie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube Straße 40, 06097 Halle, Germany
| | - Uwe Kirchhefer
- Institut für Pharmakologie und Toxikologie, Domagkstraße 12, Westfälische Wilhelms-Universität, 48149 Münster, Germany
| | - Stefan Dhein
- Rudolf-Boehm Institut für Pharmakologie und Toxikologie, Härtelstraße 16-18, Universität Leipzig, 04107 Leipzig, Germany
| | - Ulrich Gergs
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Magdeburger Straße 4, Martin-Luther-Universität Halle-Wittenberg, 06097 Halle, Germany
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Neumann J, Hofmann B, Dhein S, Gergs U. Role of Dopamine in the Heart in Health and Disease. Int J Mol Sci 2023; 24:ijms24055042. [PMID: 36902474 PMCID: PMC10003060 DOI: 10.3390/ijms24055042] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 01/04/2023] [Revised: 02/25/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
Dopamine has effects on the mammalian heart. These effects can include an increase in the force of contraction, and an elevation of the beating rate and the constriction of coronary arteries. Depending on the species studied, positive inotropic effects were strong, very modest, or absent, or even negative inotropic effects occurred. We can discern five dopamine receptors. In addition, the signal transduction by dopamine receptors and the regulation of the expression of cardiac dopamine receptors will be of interest to us, because this might be a tempting area of drug development. Dopamine acts in a species-dependent fashion on these cardiac dopamine receptors, but also on cardiac adrenergic receptors. We will discuss the utility of drugs that are currently available as tools to understand cardiac dopamine receptors. The molecule dopamine itself is present in the mammalian heart. Therefore, cardiac dopamine might act as an autocrine or paracrine compound in the mammalian heart. Dopamine itself might cause cardiac diseases. Moreover, the cardiac function of dopamine and the expression of dopamine receptors in the heart can be altered in diseases such as sepsis. Various drugs for cardiac and non-cardiac diseases are currently in the clinic that are, at least in part, agonists or antagonists at dopamine receptors. We define the research needs in order to understand dopamine receptors in the heart better. All in all, an update on the role of dopamine receptors in the human heart appears to be clinically relevant, and is thus presented here.
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Affiliation(s)
- Joachim Neumann
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, 06097 Halle, Germany
- Correspondence: ; Tel.: +49-345-557-1686; Fax: +49-345-557-1835
| | - Britt Hofmann
- Herzchirurgie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, 06097 Halle, Germany
| | - Stefan Dhein
- Medizinische Fakultät, Rudolf-Boehm-Institut für Pharmakologie und Toxikologie, Universität Leipzig, 04107 Leipzig, Germany
| | - Ulrich Gergs
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, 06097 Halle, Germany
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Neumann J, Hofmann B, Dhein S, Gergs U. Cardiac Roles of Serotonin (5-HT) and 5-HT-Receptors in Health and Disease. Int J Mol Sci 2023; 24:ijms24054765. [PMID: 36902195 PMCID: PMC10003731 DOI: 10.3390/ijms24054765] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [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: 01/21/2023] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023] Open
Abstract
Serotonin acts solely via 5-HT4-receptors to control human cardiac contractile function. The effects of serotonin via 5-HT4-receptors lead to positive inotropic and chronotropic effects, as well as arrhythmias, in the human heart. In addition, 5-HT4-receptors may play a role in sepsis, ischaemia, and reperfusion. These presumptive effects of 5-HT4-receptors are the focus of the present review. We also discuss the formation and inactivation of serotonin in the body, namely, in the heart. We identify cardiovascular diseases where serotonin might play a causative or additional role. We address the mechanisms which 5-HT4-receptors can use for cardiac signal transduction and their possible roles in cardiac diseases. We define areas where further research in this regard should be directed in the future, and identify animal models that might be generated to this end. Finally, we discuss in what regard 5-HT4-receptor agonists or antagonists might be useful drugs that could enter clinical practice. Serotonin has been the target of many studies for decades; thus, we found it timely to summarise our current knowledge here.
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Affiliation(s)
- Joachim Neumann
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097 Halle, Germany
- Correspondence:
| | - Britt Hofmann
- Cardiac Surgery, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097 Halle, Germany
| | - Stefan Dhein
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Universität Leipzig, D-04109 Leipzig, Germany
| | - Ulrich Gergs
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097 Halle, Germany
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Jacob H, Braekow P, Schwarz R, Höhm C, Kirchhefer U, Hofmann B, Neumann J, Gergs U. Ergotamine Stimulates Human 5-HT 4-Serotonin Receptors and Human H 2-Histamine Receptors in the Heart. Int J Mol Sci 2023; 24:ijms24054749. [PMID: 36902177 PMCID: PMC10003312 DOI: 10.3390/ijms24054749] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
Ergotamine (2'-methyl-5'α-benzyl-12'-hydroxy-3',6',18-trioxoergotaman) is a tryptamine-related alkaloid from the fungus Claviceps purpurea. Ergotamine is used to treat migraine. Ergotamine can bind to and activate several types of 5-HT1-serotonin receptors. Based on the structural formula of ergotamine, we hypothesized that ergotamine might stimulate 5-HT4-serotonin receptors or H2-histamine receptors in the human heart. We observed that ergotamine exerted concentration- and time-dependent positive inotropic effects in isolated left atrial preparations in H2-TG (mouse which exhibits cardiac-specific overexpression of the human H2-histamine receptor). Similarly, ergotamine increased force of contraction in left atrial preparations from 5-HT4-TG (mouse which exhibits cardiac-specific overexpression of the human 5-HT4-serotonin receptor). An amount of 10 µM ergotamine increased the left ventricular force of contraction in isolated retrogradely perfused spontaneously beating heart preparations of both 5-HT4-TG and H2-TG. In the presence of the phosphodiesterase inhibitor cilostamide (1 µM), ergotamine 10 µM exerted positive inotropic effects in isolated electrically stimulated human right atrial preparations, obtained during cardiac surgery, that were attenuated by 10 µM of the H2-histamine receptor antagonist cimetidine, but not by 10 µM of the 5-HT4-serotonin receptor antagonist tropisetron. These data suggest that ergotamine is in principle an agonist at human 5-HT4-serotonin receptors as well at human H2-histamine receptors. Ergotamine acts as an agonist on H2-histamine receptors in the human atrium.
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Affiliation(s)
- Hannes Jacob
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Pauline Braekow
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Rebecca Schwarz
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Christian Höhm
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Uwe Kirchhefer
- Institute for Pharmacology and Toxicology, Medical Faculty, Westfälische Wilhelms-Universität, 48149 Münster, Germany
| | - Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle, 06120 Halle (Saale), Germany
| | - Joachim Neumann
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
- Correspondence:
| | - Ulrich Gergs
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
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Neumann J, Azatsian K, Höhm C, Hofmann B, Gergs U. Cardiac effects of ephedrine, norephedrine, mescaline, and 3,4-methylenedioxymethamphetamine (MDMA) in mouse and human atrial preparations. Naunyn Schmiedebergs Arch Pharmacol 2023; 396:275-287. [PMID: 36319858 PMCID: PMC9831963 DOI: 10.1007/s00210-022-02315-2] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/20/2022] [Indexed: 01/11/2023]
Abstract
The use of recreational drugs like ephedrine, norephedrine, 3,4-methylenedioxymethamphetamine (MDMA), and mescaline can lead to intoxication and, at worst, to death. One reason for a fatal course of intoxication with these drugs might lie in cardiac arrhythmias. To the best of our knowledge, their inotropic effects have not yet been studied in isolated human cardiac preparations. Therefore, we measured inotropic effects of the hallucinogenic drugs ephedrine, norephedrine, mescaline, and MDMA in isolated mouse left atrial (mLA) and right atrial (mRA) preparations as well as in human right atrial (hRA) preparations obtained during cardiac surgery. Under these experimental conditions, ephedrine, norephedrine, and MDMA increased force of contraction (mLA, hRA) and beating rate (mRA) in a time- and concentration-dependent way, starting at 1-3 µM but these drugs were less effective than isoprenaline. Mescaline alone or in the presence of phosphodiesterase inhibitors did not increase force in mLA or hRA. The positive inotropic effects of ephedrine, norephedrine, or MDMA were accompanied by increases in the rate of tension and relaxation and by shortening of time of relaxation and, moreover, by an augmented phosphorylation state of the inhibitory subunit of troponin in hRA. All effects were greatly attenuated by cocaine (10 µM) or propranolol (10 µM) treatment. In summary, the hallucinogenic drugs ephedrine, norephedrine, and MDMA, but not mescaline, increased force of contraction and increased protein phosphorylation presumably, in part, by a release of noradrenaline in isolated human atrial preparations and thus can be regarded as indirect sympathomimetic drugs in the human atrium.
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Affiliation(s)
- Joachim Neumann
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 4, D-06097, Halle, Germany
| | - Karyna Azatsian
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 4, D-06097, Halle, Germany
| | - Christian Höhm
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 4, D-06097, Halle, Germany
| | - Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle, D-06097, Halle, Germany
| | - Ulrich Gergs
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 4, D-06097, Halle, Germany.
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Abella LMR, Höhm C, Hofmann B, Gergs U, Neumann J. Effects of omecamtiv mecarbil and mavacamten in isolated human atrium. Naunyn Schmiedebergs Arch Pharmacol 2023; 396:499-511. [PMID: 36399186 PMCID: PMC9898377 DOI: 10.1007/s00210-022-02333-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2022]
Abstract
Heart failure is a syndrome that can result from impaired heart muscle contractions like in dilative cardiomyopathy but also from hypertrophic obstructive cardiomyopathy (HOCOM). A pharmacological therapy might lie in Ca2+-sensitizing or Ca2+-desensitizing drugs, respectively. Such drugs are thought to be omecamtiv mecarbil (OME) and mavacamten (MYK-461), respectively. Their function in contracting human muscle is not fully understood and was the focus of the present study. OME from 1 nM to 10 µM cumulatively applied failed to raise force of contraction in human right atrial preparations strips (HAP) or mouse left atrial preparations (LA). However, OME prolonged time to peak tension and time of relaxation in HAP and LA but did not alter the beating rate in right atrial preparations from mice (RA). In contrast, MYK-461 (10 nM to 10 µM) reduced concentration- and time-dependently force of contraction in HAP and LA. MYK-461 (10 µM) did not affect the beating rate in RA. In summary, the present data failed to detect an increase in force of contraction for OME, in human and mouse atrium. In contrast, a Ca2+ desensitizer studied for comparison was able to reduce force of contraction in HAP and LA. We conclude that putative beneficial effects of OME in dilated cardiomyopathy cannot be explained by positive inotropic effects in the HAP, whereas beneficial functional effects of MYK-461 in HOCOM can be explained by negative inotropic effects in HAP.
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Affiliation(s)
- Lina Maria Rayo Abella
- grid.9018.00000 0001 0679 2801Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 4, D-06097 Halle, Germany
| | - Christian Höhm
- grid.9018.00000 0001 0679 2801Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 4, D-06097 Halle, Germany
| | - Britt Hofmann
- grid.9018.00000 0001 0679 2801Cardiac Surgery, Medical Faculty, Martin Luther University Halle-Wittenberg, D-06097 Halle, Germany
| | - Ulrich Gergs
- grid.9018.00000 0001 0679 2801Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 4, D-06097 Halle, Germany
| | - Joachim Neumann
- Institute for Pharmacology and Toxicology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 4, D-06097, Halle, Germany.
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Schwarz R, Hofmann B, Gergs U, Neumann J. Cantharidin attenuates the effect of carbachol in isolated human atrium. J Mol Cell Cardiol 2022. [DOI: 10.1016/j.yjmcc.2022.08.264] [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: 01/01/2023]
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Abella LMR, Hofmann B, Gerds U, Neumann J. Effects of omecamtiv mecarbil and mavacamten 461 in isolated human atrium. J Mol Cell Cardiol 2022. [DOI: 10.1016/j.yjmcc.2022.08.265] [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: 01/01/2023]
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Abella LMR, Hoffmann R, Neumann J, Hofmann B, Gergs U. Levosimendan increases the phosphorylation state of phospholamban in the isolated human atrium. Naunyn-Schmiedeberg's Arch Pharmacol 2022; 396:669-682. [PMID: 36445386 PMCID: PMC10042762 DOI: 10.1007/s00210-022-02348-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 11/21/2022] [Indexed: 12/02/2022]
Abstract
Abstract
Levosimendan (up to 10 µM) given alone failed to increase force of contraction in isolated electrically stimulated (1 Hz) left atrial (LA) preparations from wild-type mice. Only in the additional presence of 0.1 µM rolipram, an inhibitor of the activity of phosphodiesterase IV, levosimendan increased force of contraction in LA and increased the phosphorylation state of phospholamban at amino acid serine 16. Levosimendan alone increased the beating rate in isolated spontaneously beating right atrial preparations from mice and this effect was potentiated by rolipram. The positive inotropic and the positive chronotropic effects of levosimendan in mouse atrial preparations were attenuated by 10 µM propranolol. Finally, we studied the contractile effects of levosimendan in isolated electrically stimulated (1 Hz) right atrial preparations from the human atrium (HAP), obtained during cardiac surgery. We detected concentration-dependent positive inotropic effects of levosimendan alone that reached plateau at 1 µM levosimendan in HAP (n = 11). Levosimendan shortened time of tension relaxation in HAP. Cilostamide (1 µM), an inhibitor of phosphodiesterase III, or propranolol (10 µM) blocked the positive inotropic effect of levosimendan in HAP. Levosimendan (1 µM) alone increased in HAP the phosphorylation state of phospholamban. In conclusion, we present evidence that levosimendan acts via phosphodiesterase III inhibition in the human atrium leading to phospholamban phosphorylation and thus explaining the positive inotropic effects of levosimendan in HAP.
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Benke K, Korça E, Boltjes A, Stengl R, Hofmann B, Matin M, Krohe K, Yakobus Y, Michaelsen J, Khizaneishvili L, Szabó G, Veres G. Preventive Impella® Support in High-Risk Patients Undergoing Cardiac Surgery. J Clin Med 2022; 11:jcm11185404. [PMID: 36143050 PMCID: PMC9504963 DOI: 10.3390/jcm11185404] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/05/2022] [Accepted: 09/11/2022] [Indexed: 12/02/2022] Open
Abstract
Background: Patients with severely reduced LV-EF ≤ 30% undergoing CABG have a high risk for postoperative cardiogenic shock. The optimal timing of an adequate hemodynamic support has an impact on short- and midterm mortality after CABG. This study aimed to assess the prophylactic use of the Impella pump in high-risk patients undergoing elective cardiac surgery. Methods: In this single-center retrospective study, 14 patients with LV-EF (≤30%) undergoing cardiac surgery received a prophylactic, perioperative Impella (5.0, 5.5) support between 2020 and 2022. Results: The mean age at surgery was 64.2 ± 2.6 years, the mean preoperative LV-EF was 20.7% ± 1.56%. The duration of Impella support was 4 (3–7.8) days and the 30-day survival rate was 92.85%. Acute renal failure occurred in four patients who were dialyzed on average for 1.2 ± 0.7 days. Mechanical ventilation was needed for 1.75 (0.9–2.7) days. Time to inotrope/vasopressor independence was 2 (0.97–7.25) days with a highest lactate level (24 h postoperatively) of 3.8 ± 0.6 mmol/l. Postoperative LV-EF showed a significant improvement when compared to preoperative LV-EF (29.1% ± 2.6% vs. 20.7% ± 1.56% (p = 0.022)). Conclusion: The prophylactic Impella application seems to be a safe approach to improve the outcomes of this patient population.
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Affiliation(s)
- Kálmán Benke
- Department of Cardiac Surgery, University Hospital Halle (Saale), Martin-Luther University Halle-Wittenberg, 06120 Halle, Germany
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary
| | - Edina Korça
- Department of Cardiac Surgery, University Hospital Halle (Saale), Martin-Luther University Halle-Wittenberg, 06120 Halle, Germany
| | - Anniek Boltjes
- Department of Cardiac Surgery, University Hospital Halle (Saale), Martin-Luther University Halle-Wittenberg, 06120 Halle, Germany
| | - Roland Stengl
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary
| | - Britt Hofmann
- Department of Cardiac Surgery, University Hospital Halle (Saale), Martin-Luther University Halle-Wittenberg, 06120 Halle, Germany
| | - Meradjoddin Matin
- Department of Cardiac Surgery, University Hospital Halle (Saale), Martin-Luther University Halle-Wittenberg, 06120 Halle, Germany
| | - Katharina Krohe
- Department of Cardiac Surgery, University Hospital Halle (Saale), Martin-Luther University Halle-Wittenberg, 06120 Halle, Germany
| | - Yuliana Yakobus
- Department of Cardiac Surgery, University Hospital Halle (Saale), Martin-Luther University Halle-Wittenberg, 06120 Halle, Germany
| | - Jens Michaelsen
- Department of Cardiac Surgery, University Hospital Halle (Saale), Martin-Luther University Halle-Wittenberg, 06120 Halle, Germany
| | - Levan Khizaneishvili
- Department of Cardiac Surgery, University Hospital Halle (Saale), Martin-Luther University Halle-Wittenberg, 06120 Halle, Germany
| | - Gábor Szabó
- Department of Cardiac Surgery, University Hospital Halle (Saale), Martin-Luther University Halle-Wittenberg, 06120 Halle, Germany
| | - Gábor Veres
- Department of Cardiac Surgery, University Hospital Halle (Saale), Martin-Luther University Halle-Wittenberg, 06120 Halle, Germany
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary
- Correspondence: ; Tel.: +49-(0)-345-557-2759; Fax: +49-(0)-345-557-2782
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Längrich T, Bork K, Horstkorte R, Weber V, Hofmann B, Fuszard M, Olzscha H. Disturbance of Key Cellular Subproteomes upon Propofol Treatment Is Associated with Increased Permeability of the Blood-Brain Barrier. Proteomes 2022; 10:proteomes10030028. [PMID: 35997440 PMCID: PMC9397097 DOI: 10.3390/proteomes10030028] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Propofol is a short-acting anesthetic, which is often used for induction and maintenance of general anesthesia, sedation for mechanically ventilated adults and procedural sedation. Several side effects of propofol are known and a substantial number of patients suffer from post-operative delirium after propofol application. In this study, we analyzed the effect of propofol on the function and protein expression profile on a proteome-wide scale. Methods: We cultured human brain microvascular endothelial cells in absence and presence of propofol and analyzed the permeability of the blood-brain barrier (BBB) by fluorescein passage and protein abundance on a proteome-wide scale by mass spectrometry. Results: Propofol interfered with the function of the blood-brain barrier. This was not due to decreased adhesion of propofol-treated human brain microvascular endothelial cells. The proteomic analysis revealed that some key pathways in these cells were disturbed, such as oxygen metabolism, DNA damage recognition and response to stress. Conclusions: Propofol has strong effects on protein expression which could explain several side effects of propofol.
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Affiliation(s)
- Timo Längrich
- Institut für Physiologische Chemie, Martin-Luther-Universität Halle-Wittenberg, Hollystr. 1, 06114 Halle (Saale), Germany
| | - Kaya Bork
- Institut für Physiologische Chemie, Martin-Luther-Universität Halle-Wittenberg, Hollystr. 1, 06114 Halle (Saale), Germany
| | - Rüdiger Horstkorte
- Institut für Physiologische Chemie, Martin-Luther-Universität Halle-Wittenberg, Hollystr. 1, 06114 Halle (Saale), Germany
| | - Veronika Weber
- Institut für Physiologische Chemie, Martin-Luther-Universität Halle-Wittenberg, Hollystr. 1, 06114 Halle (Saale), Germany
| | - Britt Hofmann
- Klinik und Poliklinik für Herzchirurgie, Universitätsklinikum Halle (Saale), Ernst-Grube-Str. 20, 06120 Halle (Saale), Germany
| | - Matt Fuszard
- Core Facility—Proteomic Mass Spectrometry, Proteinzentrum Charles Tanford, Kurt-Mothes-Straße 3a, 06120 Halle (Saale), Germany
| | - Heidi Olzscha
- Institut für Physiologische Chemie, Martin-Luther-Universität Halle-Wittenberg, Hollystr. 1, 06114 Halle (Saale), Germany
- Medical School Hamburg MSH, University of Applied Sciences and Medical University, Institute of Molecular Medicine, Am Sandtorkai 76, 20457 Hamburg, Germany
- Correspondence:
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Schulz S, Hofmann B, Grollmitz J, Friebe L, Kohnert M, Schaller HG, Reichert S. Campylobacter Species of the Oral Microbiota as Prognostic Factor for Cardiovascular Outcome after Coronary Artery Bypass Grafting Surgery. Biomedicines 2022; 10:biomedicines10081801. [PMID: 35892701 PMCID: PMC9332846 DOI: 10.3390/biomedicines10081801] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background: The oral microbiota has been implicated in a variety of systemic diseases, including cardiovascular (CV) disease. The main objective of this study (DRKS-ID: DRKS00015776) was to evaluate the prognostic importance of the oral microbiota for further CV events in patients undergoing coronary artery bypass grafting surgery (3-year follow-up). Methods: In this longitudinal cohort study, 102 CV patients were enrolled, of whom 95 completed the 3-year follow-up. The CV outcome was assessed using the major adverse cardiac and cerebrovascular events criteria. To evaluate subgingival colonization, 16S rRNA genes were amplified, targeting the V3/V4 region (Illumina MiSeq). Results: Regarding the specific number of operational taxonomic units (OTUs), no significant differences in CV outcome were determined (alpha diversity, Shannon index). In linear discriminant analyses and t-tests, the disease-specific differences in the beta diversity of the microbiota composition were evaluated. It was evident that bacteria species of the genus Campylobacter were significantly more prevalent in patients with a secondary CV event (p = 0.015). This hierarchical order also includes Campylobacter rectus, which is considered to be of comprehensive importance in both periodontal and CV diseases. Conclusions: Here, we proved that subgingival occurrence of Campylobacter species has prognostic relevance for cardiovascular outcomes in CV patients undergoing coronary artery bypass grafting.
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Affiliation(s)
- Susanne Schulz
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (J.G.); (L.F.); (M.K.); (H.-G.S.); (S.R.)
- Correspondence:
| | - Britt Hofmann
- Department of Cardiothoracic Surgery, Heart Centre of the University Clinics Halle (Saale), Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany;
| | - Julia Grollmitz
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (J.G.); (L.F.); (M.K.); (H.-G.S.); (S.R.)
| | - Lisa Friebe
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (J.G.); (L.F.); (M.K.); (H.-G.S.); (S.R.)
| | - Michael Kohnert
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (J.G.); (L.F.); (M.K.); (H.-G.S.); (S.R.)
- Department of Cardiothoracic Surgery, Heart Centre of the University Clinics Halle (Saale), Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany;
| | - Hans-Günter Schaller
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (J.G.); (L.F.); (M.K.); (H.-G.S.); (S.R.)
| | - Stefan Reichert
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (J.G.); (L.F.); (M.K.); (H.-G.S.); (S.R.)
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Diab M, Lehmann T, Bothe W, Akhyari P, Platzer S, Wendt D, Deppe AC, Strauch J, Hagel S, Günther A, Faerber G, Sponholz C, Franz M, Scherag A, Velichkov I, Silaschi M, Fassl J, Hofmann B, Lehmann S, Schramm R, Fritz G, Szabo G, Wahlers T, Matschke K, Lichtenberg A, Pletz MW, Gummert JF, Beyersdorf F, Hagl C, Borger MA, Bauer M, Brunkhorst FM, Doenst T. Cytokine Hemoadsorption During Cardiac Surgery Versus Standard Surgical Care for Infective Endocarditis (REMOVE): Results From a Multicenter Randomized Controlled Trial. Circulation 2022; 145:959-968. [PMID: 35213213 DOI: 10.1161/circulationaha.121.056940] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [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: 01/23/2023]
Abstract
BACKGROUND Cardiac surgery often represents the only treatment option in patients with infective endocarditis (IE). However, IE surgery may lead to a sudden release of inflammatory mediators, which is associated with postoperative organ dysfunction. We investigated the effect of hemoadsorption during IE surgery on postoperative organ dysfunction. METHODS This multicenter, randomized, nonblinded, controlled trial assigned patients undergoing cardiac surgery for IE to hemoadsorption (integration of CytoSorb to cardiopulmonary bypass) or control. The primary outcome (change in sequential organ failure assessment score [ΔSOFA]) was defined as the difference between the mean total postoperative SOFA score, calculated maximally to the 9th postoperative day, and the basal SOFA score. The analysis was by modified intention to treat. A predefined intergroup comparison was performed using a linear mixed model for ΔSOFA including surgeon and baseline SOFA score as fixed effect covariates and with the surgical center as random effect. The SOFA score assesses dysfunction in 6 organ systems, each scored from 0 to 4. Higher scores indicate worsening dysfunction. Secondary outcomes were 30-day mortality, duration of mechanical ventilation, and vasopressor and renal replacement therapy. Cytokines were measured in the first 50 patients. RESULTS Between January 17, 2018, and January 31, 2020, a total of 288 patients were randomly assigned to hemoadsorption (n=142) or control (n=146). Four patients in the hemoadsorption and 2 in the control group were excluded because they did not undergo surgery. The primary outcome, ΔSOFA, did not differ between the hemoadsorption and the control group (1.79±3.75 and 1.93±3.53, respectively; 95% CI, -1.30 to 0.83; P=0.6766). Mortality at 30 days (21% hemoadsorption versus 22% control; P=0.782), duration of mechanical ventilation, and vasopressor and renal replacement therapy did not differ between groups. Levels of interleukin-1β and interleukin-18 at the end of integration of hemoadsorption to cardiopulmonary bypass were significantly lower in the hemoadsorption than in the control group. CONCLUSIONS This randomized trial failed to demonstrate a reduction in postoperative organ dysfunction through intraoperative hemoadsorption in patients undergoing cardiac surgery for IE. Although hemoadsorption reduced plasma cytokines at the end of cardiopulmonary bypass, there was no difference in any of the clinically relevant outcome measures. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT03266302.
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Affiliation(s)
- Mahmoud Diab
- Department of Cardiothoracic Surgery (M.D., G. Faerber, I.V., T.D.), Jena University Hospital-Friedrich Schiller University of Jena, Germany.,Center for Sepsis Control and Care (M.D., T.L., S.P., A.S., M.B., F.M.B.), Jena University Hospital-Friedrich Schiller University of Jena, Germany
| | - Thomas Lehmann
- Center for Sepsis Control and Care (M.D., T.L., S.P., A.S., M.B., F.M.B.), Jena University Hospital-Friedrich Schiller University of Jena, Germany.,Center for Clinical Studies (T.L., S.P., A.S., F.M.B.), Jena University Hospital-Friedrich Schiller University of Jena, Germany
| | - Wolfgang Bothe
- Department of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany (W.B., F.B.)
| | - Payam Akhyari
- Department of Cardiothoracic Surgery, Heinrich-Heine-University Duesseldorf, Germany (P.A., A.L.)
| | - Stephanie Platzer
- Center for Sepsis Control and Care (M.D., T.L., S.P., A.S., M.B., F.M.B.), Jena University Hospital-Friedrich Schiller University of Jena, Germany.,Center for Clinical Studies (T.L., S.P., A.S., F.M.B.), Jena University Hospital-Friedrich Schiller University of Jena, Germany
| | - Daniel Wendt
- Department of Thoracic and Cardiovascular Surgery, University Hospital Essen, Germany (D.W.)
| | - Antje-Christin Deppe
- Department of Cardiothoracic Surgery, Heart Center of the University of Cologne, Germany (A.-C.D., T.W.)
| | - Justus Strauch
- Department of Cardiac and Thoracic Surgery, Bergmannsheil University Hospitals, Bochum, Germany (J.S.)
| | - Stefan Hagel
- Institute for Infectious Diseases and Infection Control (S.H., M.W.P.), Jena University Hospital-Friedrich Schiller University of Jena, Germany
| | - Albrecht Günther
- Department of Neurology (A.G.), Jena University Hospital-Friedrich Schiller University of Jena, Germany
| | - Gloria Faerber
- Department of Cardiothoracic Surgery (M.D., G. Faerber, I.V., T.D.), Jena University Hospital-Friedrich Schiller University of Jena, Germany
| | - Christoph Sponholz
- Department of Anesthesiology and Critical Care Medicine (C.S., M.B.), Jena University Hospital-Friedrich Schiller University of Jena, Germany
| | - Marcus Franz
- Department of Internal Medicine I (M.F.), Jena University Hospital-Friedrich Schiller University of Jena, Germany
| | - André Scherag
- Center for Sepsis Control and Care (M.D., T.L., S.P., A.S., M.B., F.M.B.), Jena University Hospital-Friedrich Schiller University of Jena, Germany.,Center for Clinical Studies (T.L., S.P., A.S., F.M.B.), Jena University Hospital-Friedrich Schiller University of Jena, Germany.,Institute of Medical Statistics, Computer and Data Sciences (A.S.), Jena University Hospital-Friedrich Schiller University of Jena, Germany
| | - Ilia Velichkov
- Department of Cardiothoracic Surgery (M.D., G. Faerber, I.V., T.D.), Jena University Hospital-Friedrich Schiller University of Jena, Germany
| | - Miriam Silaschi
- Clinic and Polyclinic for Cardiac Surgery, University Hospital Bonn, Germany (M.S.)
| | - Jens Fassl
- Institute for Cardiac Anesthesiology, Dresden Heart Center, University Hospital at the Technical University Dresden, Germany (J.F.)
| | - Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), Halle, Germany (B.H., G.S.)
| | - Sven Lehmann
- Department of Cardiac Surgery, Heart Center Leipzig, Germany (S.L., M.A.B.)
| | - Rene Schramm
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Bad Oeynhausen, Germany (R.S., J.F.G.)
| | - Georg Fritz
- Department of Anesthesiology, Intensive Care and Pain Therapy, Heart Center Brandenburg, Immanuel Clinic Bernau, Germany (G. Fritz)
| | - Gabor Szabo
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), Halle, Germany (B.H., G.S.)
| | - Thorsten Wahlers
- Department of Cardiothoracic Surgery, Heart Center of the University of Cologne, Germany (A.-C.D., T.W.)
| | - Klaus Matschke
- Department of Cardiac Surgery, Heart Center Dresden, Germany (K.M.)
| | - Artur Lichtenberg
- Department of Cardiothoracic Surgery, Heinrich-Heine-University Duesseldorf, Germany (P.A., A.L.)
| | - Mathias W Pletz
- Institute for Infectious Diseases and Infection Control (S.H., M.W.P.), Jena University Hospital-Friedrich Schiller University of Jena, Germany
| | - Jan F Gummert
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Bad Oeynhausen, Germany (R.S., J.F.G.)
| | - Friedhelm Beyersdorf
- Department of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany (W.B., F.B.)
| | - Christian Hagl
- Department of Cardiac Surgery, Ludwig Maximilian University Munich, Germany (C.H.).,DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany (C.H.)
| | - Michael A Borger
- Department of Cardiac Surgery, Heart Center Leipzig, Germany (S.L., M.A.B.)
| | - Michael Bauer
- Center for Sepsis Control and Care (M.D., T.L., S.P., A.S., M.B., F.M.B.), Jena University Hospital-Friedrich Schiller University of Jena, Germany.,Department of Anesthesiology and Critical Care Medicine (C.S., M.B.), Jena University Hospital-Friedrich Schiller University of Jena, Germany
| | - Frank M Brunkhorst
- Center for Sepsis Control and Care (M.D., T.L., S.P., A.S., M.B., F.M.B.), Jena University Hospital-Friedrich Schiller University of Jena, Germany.,Center for Clinical Studies (T.L., S.P., A.S., F.M.B.), Jena University Hospital-Friedrich Schiller University of Jena, Germany
| | - Torsten Doenst
- Department of Cardiothoracic Surgery (M.D., G. Faerber, I.V., T.D.), Jena University Hospital-Friedrich Schiller University of Jena, Germany
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Neumann J, Kirchhefer U, Dhein S, Hofmann B, Gergs U. The Roles of Cardiovascular H 2-Histamine Receptors Under Normal and Pathophysiological Conditions. Front Pharmacol 2022; 12:732842. [PMID: 34987383 PMCID: PMC8720924 DOI: 10.3389/fphar.2021.732842] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/02/2021] [Indexed: 12/11/2022] Open
Abstract
This review addresses pharmacological, structural and functional relationships among H2-histamine receptors and H1-histamine receptors in the mammalian heart. The role of both receptors in the regulation of force and rhythm, including their electrophysiological effects on the mammalian heart, will then be discussed in context. The potential clinical role of cardiac H2-histamine-receptors in cardiac diseases will be examined. The use of H2-histamine receptor agonists to acutely increase the force of contraction will be discussed. Special attention will be paid to the potential role of cardiac H2-histamine receptors in the genesis of cardiac arrhythmias. Moreover, novel findings on the putative role of H2-histamine receptor antagonists in treating chronic heart failure in animal models and patients will be reviewed. Some limitations in our biochemical understanding of the cardiac role of H2-histamine receptors will be discussed. Recommendations for further basic and translational research on cardiac H2-histamine receptors will be offered. We will speculate whether new knowledge might lead to novel roles of H2-histamine receptors in cardiac disease and whether cardiomyocyte specific H2-histamine receptor agonists and antagonists should be developed.
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Affiliation(s)
- Joachim Neumann
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Uwe Kirchhefer
- Institut für Pharmakologie und Toxikologie, Westfälische Wilhelms-Universität, Münster, Germany
| | - Stefan Dhein
- Landratsamt Altenburger Land, Altenburg, Germany
| | - Britt Hofmann
- Herzchirurgie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Ulrich Gergs
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
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35
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Neumann J, Schwarzer D, Fehse C, Schwarz R, Marusakova M, Kirchhefer U, Hofmann B, Gergs U. Correction to: Functional interaction of H 2‑receptors and 5-HT 4‑receptors in atrial tissues isolated from double transgenic mice and from human patients. Naunyn Schmiedebergs Arch Pharmacol 2021; 394:2475-2476. [PMID: 34739564 PMCID: PMC8594249 DOI: 10.1007/s00210-021-02167-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Joachim Neumann
- Institut für Pharmakologie und Toxikologie, Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Magdeburger Str. 4, 06112, Halle, Germany.
| | - Denise Schwarzer
- Institut für Pharmakologie und Toxikologie, Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Magdeburger Str. 4, 06112, Halle, Germany
| | - Charlotte Fehse
- Institut für Pharmakologie und Toxikologie, Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Magdeburger Str. 4, 06112, Halle, Germany
| | - Rebecca Schwarz
- Institut für Pharmakologie und Toxikologie, Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Magdeburger Str. 4, 06112, Halle, Germany
| | - Margareta Marusakova
- Institut für Pharmakologie und Toxikologie, Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Magdeburger Str. 4, 06112, Halle, Germany.,Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in Bratislava, Bratislava, Slovakia
| | - Uwe Kirchhefer
- Institut für Pharmakologie und Toxikologie, Westfälische Wilhelms-Universität, Medizinische Fakultät, Domagkstr. 12, 48149, Münster, Germany
| | - Britt Hofmann
- Cardiac Surgery, Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, 06097, Halle, Germany
| | - Ulrich Gergs
- Institut für Pharmakologie und Toxikologie, Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Magdeburger Str. 4, 06112, Halle, Germany
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Gergs U, Büxel ML, Bresinsky M, Kirchhefer U, Fehse C, Höring C, Hofmann B, Marušáková M, Čináková A, Schwarz R, Pockes S, Neumann J. Cardiac Effects of Novel Histamine H 2 Receptor Agonists. J Pharmacol Exp Ther 2021; 379:223-234. [PMID: 34535565 DOI: 10.1124/jpet.121.000822] [Citation(s) in RCA: 3] [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] [Received: 07/02/2021] [Accepted: 09/14/2021] [Indexed: 01/17/2023] Open
Abstract
In an integrative approach, we studied cardiac effects of recently published novel H2 receptor agonists in the heart of mice that overexpress the human H2 receptor (H2-TG mice) and littermate wild type (WT) control mice and in isolated electrically driven muscle preparations from patients undergoing cardiac surgery. Under our experimental conditions, the H2 receptor agonists UR-Po563, UR-MB-158, and UR-MB-159 increased force of contraction in left atrium from H2-TG mice with pEC50 values of 8.27, 9.38, and 8.28, respectively, but not in WT mice. Likewise, UR-Po563, UR-MB-158, and UR-MB-159 increased the beating rate in right atrium from H2-TG mice with pEC50 values of 9.01, 9.24, and 7.91, respectively, but not from WT mice. These effects could be antagonized by famotidine, a H2 receptor antagonist. UR-Po563 (1 µM) increased force of contraction in Langendorff-perfused hearts from H2-TG but not WT mice. Similarly, UR-Po563, UR-MB-158, or UR-MB-159 increased the left ventricular ejection fraction in echocardiography of H2-TG mice. Finally, UR-Po563 increased force of contraction in isolated human right atrial muscle strips. The contractile effects of UR-Po563 in H2-TG mice were accompanied by an increase in the phosphorylation state of phospholamban. In summary, we report here three recently developed agonists functionally stimulating human cardiac H2 receptors in vitro and in vivo. We speculate that these compounds might be of some merit to treat neurologic disorders if their cardiac effects are blocked by concomitantly applied receptor antagonists that cannot pass through the blood-brain barrier or might be useful to treat congestive heart failure in patients. SIGNIFICANCE STATEMENT: Recently, a new generation of histamine H2 receptor (H2R) agonists has been developed as possible treatment option for Alzheimer's disease. Here, possible cardiac (side) effects of these novel H2R agonists have been evaluated.
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Affiliation(s)
- Ulrich Gergs
- Institute for Pharmacology and Toxicology (U.G., M.L.B., C.F., M.M., A.C., R.S., J.N.) and Cardiac Surgery (B.H.), Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany; Institute of Pharmacy, University of Regensburg, Regensburg, Germany (M.B., C.H., S.P.); Institute for Pharmacology and Toxicology, University Hospital, Westfälische Wilhelms-Universität, Münster, Germany (U.K.); Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia (M.M., A.C.)
| | - Maren L Büxel
- Institute for Pharmacology and Toxicology (U.G., M.L.B., C.F., M.M., A.C., R.S., J.N.) and Cardiac Surgery (B.H.), Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany; Institute of Pharmacy, University of Regensburg, Regensburg, Germany (M.B., C.H., S.P.); Institute for Pharmacology and Toxicology, University Hospital, Westfälische Wilhelms-Universität, Münster, Germany (U.K.); Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia (M.M., A.C.)
| | - Merlin Bresinsky
- Institute for Pharmacology and Toxicology (U.G., M.L.B., C.F., M.M., A.C., R.S., J.N.) and Cardiac Surgery (B.H.), Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany; Institute of Pharmacy, University of Regensburg, Regensburg, Germany (M.B., C.H., S.P.); Institute for Pharmacology and Toxicology, University Hospital, Westfälische Wilhelms-Universität, Münster, Germany (U.K.); Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia (M.M., A.C.)
| | - Uwe Kirchhefer
- Institute for Pharmacology and Toxicology (U.G., M.L.B., C.F., M.M., A.C., R.S., J.N.) and Cardiac Surgery (B.H.), Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany; Institute of Pharmacy, University of Regensburg, Regensburg, Germany (M.B., C.H., S.P.); Institute for Pharmacology and Toxicology, University Hospital, Westfälische Wilhelms-Universität, Münster, Germany (U.K.); Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia (M.M., A.C.)
| | - Charlotte Fehse
- Institute for Pharmacology and Toxicology (U.G., M.L.B., C.F., M.M., A.C., R.S., J.N.) and Cardiac Surgery (B.H.), Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany; Institute of Pharmacy, University of Regensburg, Regensburg, Germany (M.B., C.H., S.P.); Institute for Pharmacology and Toxicology, University Hospital, Westfälische Wilhelms-Universität, Münster, Germany (U.K.); Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia (M.M., A.C.)
| | - Carina Höring
- Institute for Pharmacology and Toxicology (U.G., M.L.B., C.F., M.M., A.C., R.S., J.N.) and Cardiac Surgery (B.H.), Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany; Institute of Pharmacy, University of Regensburg, Regensburg, Germany (M.B., C.H., S.P.); Institute for Pharmacology and Toxicology, University Hospital, Westfälische Wilhelms-Universität, Münster, Germany (U.K.); Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia (M.M., A.C.)
| | - Britt Hofmann
- Institute for Pharmacology and Toxicology (U.G., M.L.B., C.F., M.M., A.C., R.S., J.N.) and Cardiac Surgery (B.H.), Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany; Institute of Pharmacy, University of Regensburg, Regensburg, Germany (M.B., C.H., S.P.); Institute for Pharmacology and Toxicology, University Hospital, Westfälische Wilhelms-Universität, Münster, Germany (U.K.); Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia (M.M., A.C.)
| | - Margaréta Marušáková
- Institute for Pharmacology and Toxicology (U.G., M.L.B., C.F., M.M., A.C., R.S., J.N.) and Cardiac Surgery (B.H.), Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany; Institute of Pharmacy, University of Regensburg, Regensburg, Germany (M.B., C.H., S.P.); Institute for Pharmacology and Toxicology, University Hospital, Westfälische Wilhelms-Universität, Münster, Germany (U.K.); Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia (M.M., A.C.)
| | - Aneta Čináková
- Institute for Pharmacology and Toxicology (U.G., M.L.B., C.F., M.M., A.C., R.S., J.N.) and Cardiac Surgery (B.H.), Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany; Institute of Pharmacy, University of Regensburg, Regensburg, Germany (M.B., C.H., S.P.); Institute for Pharmacology and Toxicology, University Hospital, Westfälische Wilhelms-Universität, Münster, Germany (U.K.); Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia (M.M., A.C.)
| | - Rebecca Schwarz
- Institute for Pharmacology and Toxicology (U.G., M.L.B., C.F., M.M., A.C., R.S., J.N.) and Cardiac Surgery (B.H.), Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany; Institute of Pharmacy, University of Regensburg, Regensburg, Germany (M.B., C.H., S.P.); Institute for Pharmacology and Toxicology, University Hospital, Westfälische Wilhelms-Universität, Münster, Germany (U.K.); Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia (M.M., A.C.)
| | - Steffen Pockes
- Institute for Pharmacology and Toxicology (U.G., M.L.B., C.F., M.M., A.C., R.S., J.N.) and Cardiac Surgery (B.H.), Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany; Institute of Pharmacy, University of Regensburg, Regensburg, Germany (M.B., C.H., S.P.); Institute for Pharmacology and Toxicology, University Hospital, Westfälische Wilhelms-Universität, Münster, Germany (U.K.); Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia (M.M., A.C.)
| | - Joachim Neumann
- Institute for Pharmacology and Toxicology (U.G., M.L.B., C.F., M.M., A.C., R.S., J.N.) and Cardiac Surgery (B.H.), Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany; Institute of Pharmacy, University of Regensburg, Regensburg, Germany (M.B., C.H., S.P.); Institute for Pharmacology and Toxicology, University Hospital, Westfälische Wilhelms-Universität, Münster, Germany (U.K.); Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia (M.M., A.C.)
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Gergs U, Brückner T, Hofmann B, Neumann J. The proarrhythmic effects of hypothermia in atria isolated from 5-HT 4-receptor-overexpressing mice. Eur J Pharmacol 2021; 906:174206. [PMID: 34048737 DOI: 10.1016/j.ejphar.2021.174206] [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: 03/07/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 11/16/2022]
Abstract
We investigated whether hypothermia would be arrhythmogenic in mice that overexpress the human 5-HT4 receptor only in their cardiac myocytes (5-HT4-TG). Contractile studies were performed in isolated, electrically driven (1 Hz) left and spontaneously beating right atrial preparations of 5-HT4-TG and littermate wild-type control mice (WT). Hypothermia (23 °C) decreased the force of contraction in the mouse right and left atrial preparations. Moreover, the concentration-dependent positive inotropic effects of 5-HT were blunted but still shifted to lower 5-HT concentrations in the left 5-HT4-TG atria in hypothermia compared to normothermia (37 °C). Furthermore, hypothermia increased the incidence of right atrial arrhythmias in 5-HT4-TG more than in WT mice. In contrast, at 37 °C, lowering the potassium concentration from 5.2 to 2.0 mM also induced arrhythmias in the right atrium, but with a similar incidence in WT and 5-HT4-TG mice. In contrast, 10 μM d,l-sotalol and 300 μM erythromycin did not induce arrhythmias. Hypothermia was accompanied by the increased expression of heat shock protein 70 (HSP70) in WT but not in 5-HT4-TG mice. We concluded that without the stimulation of 5-HT4-receptors by exogenous agonists, a simple temperature reduction can increase arrhythmias in 5-HT4-TG mice. It is tempting to speculate that in human patients, 5-HT4 receptors might contribute to potentially deadly hypothermia-induced arrhythmias.
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Affiliation(s)
- Ulrich Gergs
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany.
| | - Tobias Brückner
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany.
| | - Britt Hofmann
- Cardiac Surgery, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany.
| | - Joachim Neumann
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany.
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Neumann J, Grobe JM, Weisgut J, Schwelberger HG, Fogel WA, Marušáková M, Wache H, Bähre H, Buchwalow IB, Dhein S, Hofmann B, Kirchhefer U, Gergs U. Histamine can be Formed and Degraded in the Human and Mouse Heart. Front Pharmacol 2021; 12:582916. [PMID: 34045955 PMCID: PMC8144513 DOI: 10.3389/fphar.2021.582916] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 04/19/2021] [Indexed: 12/22/2022] Open
Abstract
Histamine is metabolized by several enzymes in vitro and in vivo. The relevance of this metabolism in the mammalian heart in vivo is unclear. However, histamine can exert positive inotropic effects (PIE) and positive chronotropic effects (PCE) in humans via H2-histamine receptors. In transgenic mice (H2-TG) that overexpress the human H2 receptor in cardiomyocytes but not in wild-type littermate mice (WT), histamine induced PIE and PCE in isolated left or right atrial preparations. These H2-TG were used to investigate the putative relevance of histamine degrading enzymes in the mammalian heart. Histidine, the precursor of histamine, increased force of contraction (FOC) in human atrial preparations. Moreover, histamine increased the phosphorylation state of phospholamban in human atrium. Here, we could detect histidine decarboxylase (HDC) and histamine itself in cardiomyocytes of mouse hearts. Moreover, our data indicate that histamine is subject to degradation in the mammalian heart. Inhibition of the histamine metabolizing enzymes diamine oxidase (DAO) and monoamine oxidase (MAO) shifted the concentration response curves for the PIE in H2-TG atria to the left. Moreover, activity of histamine metabolizing enzymes was present in mouse cardiac samples as well as in human atrial samples. Thus, drugs used for other indication (e.g. antidepressants) can alter histamine levels in the heart. Our results deepen our understanding of the physiological role of histamine in the mouse and human heart. Our findings might be clinically relevant because we show enzyme targets for drugs to modify the beating rate and force of the human heart.
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Affiliation(s)
- Joachim Neumann
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Juliane M Grobe
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Jacqueline Weisgut
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Hubert G Schwelberger
- Department of Visceral, Transplant and Thoracic Surgery, Molecular Biology Laboratory, Medical University Innsbruck, Innsbruck, Austria
| | | | - Margaréta Marušáková
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Hartmut Wache
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Heike Bähre
- Research Core Unit Metabolomics and Institute of Pharmacology, Hannover Medical School, Hannover, Germany
| | | | - Stefan Dhein
- Klinik für Herzchirurgie, Herzzentrum der Universität Leipzig, Leipzig, Germany
| | - Britt Hofmann
- Department of Cardiothoracic Surgery, Heart Centre of the University Clinics Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Uwe Kirchhefer
- Institut für Pharmakologie und Toxikologie, Universitätsklinikum Münster, Westfälische Wilhelms-Universität, Münster, Germany
| | - Ulrich Gergs
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
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Neumann J, Seidler T, Fehse C, Marušáková M, Hofmann B, Gergs U. Cardiovascular effects of metoclopramide and domperidone on human 5-HT 4-serotonin-receptors in transgenic mice and in human atrial preparations. Eur J Pharmacol 2021; 901:174074. [PMID: 33811834 DOI: 10.1016/j.ejphar.2021.174074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022]
Abstract
It is unclear whether metoclopramide and domperidone act on human cardiac serotonin 5-HT4-receptors. Therefore, we studied transgenic mice that only express the human 5-HT4 receptor in cardiomyocytes in the atrium and in the ventricle (5-HT4-TG), their wild type-littermates (WT) and isolated human atrial preparations. We found that only metoclopramide but not domperidone enhanced the force of contraction in left atrial preparations (pEC50 = 6.0 ± 0.1; n = 7) from 5-HT4-TG, isolated spontaneously beating right atrial preparations (pEC50 = 6.1 ± 0.1; n = 7) from 5-HT4-TG, Langendorff perfused hearts from 5-HT4-TG, living 5-HT4-TG and human right atrial muscle preparations obtained during bypass surgery of patients suffering from coronary heart disease. The maximum inotropic effect of metoclopramide was smaller (81 ± 2%) than that of 5-HT on the left atria from 5-HT4-TG. The maximum increase in the beating rate due to metoclopramide was 93 ± 2% of effect of 5-HT on right atrial preparations from 5-HT4-TG. Metoclopramide and domperidone were inactive in WT. We found that metoclopramide but not domperidone increased the phosphorylation state of phospholamban in the isolated perfused hearts or muscle strips of 5-HT4-TG, but not in WT. Metoclopramide, but not domperidone, shifted the positive inotropic or chronotropic effects of 5-HT in isolated left atrial and right atrial preparations from 5-HT4-TG dextrally, resp., to higher concentrations: the pEC50 of 5-HT for increase in force was in the absence of metoclopramide 8.6 ± 0.1 (n = 5) versus 8.0 ± 0.3 in the presence of 1 μM metoclopramide (n = 5; P < 0.05); and the beating rate was 7.8 ± 0.2 (n = 7) in the absence of metoclopramide versus 7.2 ± 0.1 in the presence of 1 μM metoclopramide (n = 6; P < 0.05). These results suggested that metoclopramide had an antagonistic effect on human cardiac 5-HT4 receptors. In summary, we showed that metoclopramide, but not domperidone, was a partial agonist at human cardiac 5-HT4-receptors.
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Affiliation(s)
- Joachim Neumann
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany
| | - Tom Seidler
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany
| | - Charlotte Fehse
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany
| | - Margaréta Marušáková
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in Bratislava, Slovakia
| | - Britt Hofmann
- Cardiac Surgery, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany
| | - Ulrich Gergs
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany.
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Neumann J, Binter MB, Fehse C, Marušáková M, Büxel ML, Kirchhefer U, Hofmann B, Gergs U. Amitriptyline functionally antagonizes cardiac H 2 histamine receptors in transgenic mice and human atria. Naunyn Schmiedebergs Arch Pharmacol 2021; 394:1251-1262. [PMID: 33625558 PMCID: PMC8208937 DOI: 10.1007/s00210-021-02065-7] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/09/2021] [Indexed: 11/29/2022]
Abstract
We have previously shown that histamine (2-(1H-imidazol-4-yl)ethanamine) exerted concentration-dependent positive inotropic effects (PIE) or positive chronotropic effects (PCE) on isolated left and right atria, respectively, of transgenic (H2R-TG) mice that overexpress the human H2 histamine receptor (H2R) in the heart; however, the effects were not seen in their wild-type (WT) littermates. Amitriptyline, which is still a highly prescribed antidepressant drug, was reported to act as antagonist on H2Rs. Here, we wanted to determine whether the histamine effects in H2R-TG were antagonized by amitriptyline. Contractile studies were performed on isolated left and right atrial preparations, isolated perfused hearts from H2R-TG and WT mice and human atrial preparations. Amitriptyline shifted the concentration-dependent PIE of histamine (1 nM-10 μM) to higher concentrations (rightward shift) in left atrial preparations from H2R-TG. Similarly, in isolated perfused hearts from H2R-TG and WT mice, histamine increased the contractile parameters and the phosphorylation state of phospholamban (PLB) at serine 16 in the H2R-TG mice, but not in the WT mice. However, the increases in contractility and PLB phosphorylation were attenuated by the addition of amitriptyline in perfused hearts from H2R-TG. In isolated electrically stimulated human atria, the PIE of histamine that was applied in increasing concentrations from 1 nM to 10 μM was reduced by 10-μM amitriptyline. In summary, we present functional evidence that amitriptyline also acts as an antagonist of contractility at H2Rs in H2R-TG mouse hearts and in the human heart which might in part explain the side effects of amitriptyline.
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Affiliation(s)
- Joachim Neumann
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany
| | - Maximilian Benedikt Binter
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany
| | - Charlotte Fehse
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany
| | - Margaréta Marušáková
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany.,Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in Bratislava, Bratislava, Slovakia
| | - Maren Luise Büxel
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany
| | - Uwe Kirchhefer
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Westfälische Wilhelms-Universität, Domagkstr. 12, D-48149, Münster, Germany
| | - Britt Hofmann
- Cardiac Surgery, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06120, Halle, Germany
| | - Ulrich Gergs
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany.
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Schulz S, Reichert S, Grollmitz J, Friebe L, Kohnert M, Hofmann B, Schaller HG, Klawonn F, Shi R. The role of Saccharibacteria (TM7) in the subginival microbiome as a predictor for secondary cardiovascular events. Int J Cardiol 2021; 331:255-261. [PMID: 33529661 DOI: 10.1016/j.ijcard.2021.01.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/11/2020] [Revised: 11/27/2020] [Accepted: 01/24/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The composition of the subgingival microbiota is of great importance in both oral and systemic diseases. However, a possible association of the oral microbiome and cardiovascular (CV) outcome has not yet been considered in a complex model. The primary objective of the study (DRKS-ID: DRKS00015776) was to assess differences in complex subgingival bacterial composition, depending on the CV outcome in patients undergoing Coronary Artery Bypass Grafting Surgery (CABG). MATERIAL AND METHODS We conducted a longitudinal cohort study enrolling 102 CV patients. After a one-year follow-up, the postoperative outcome was evaluated applying MACCE (Major Adverse Cardiac and Cerebrovascular Events) criteria. The complex oral microbiome was evaluated depending on CV outcome. The mathematical data processing included Qiime 2 software workflow and DADA2 pipeline as well as Human Oral Microbiome Database (HOMD) and Greengenes database classification. For identifying biomarkers distinguishing patients suffering from secondary CV events, the Cox Proportional Hazard Model for survival analysis was applied. RESULTS In total, 19,418 Operational Taxonomic Units (OTU) were mapped according to the HOMD and Greengenes database. No significant differences in alpha and beta diversity were linked to CV outcomes (Shannon index; Principal Coordinates Analysis). No biomarker predicting secondary CV events were identified applying the area under the receiver operating characteristic curve (AUC) model. However, in survival analysis, one biomarker of Saccharibacteria phylum (class: TM7-3, order: CW040, family: F16) was associated with the incidence of a secondary CV event (p = 0.016). CONCLUSIONS For the first time, a subgingival biomarker has been identified that supports a cardiovascular prognosis in CV patients undergoing coronary artery bypass grafting.
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Affiliation(s)
- Susanne Schulz
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, Germany.
| | - Stefan Reichert
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, Germany
| | - Julia Grollmitz
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, Germany
| | - Lisa Friebe
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, Germany
| | - Michael Kohnert
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, Germany
| | - Britt Hofmann
- Department of Cardiothoracic Surgery, Heart Centre of the University Clinics Halle (Saale), Martin-Luther-University Halle-Wittenberg, Germany
| | - Hans-Günter Schaller
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, Germany
| | - Frank Klawonn
- Biostatistics, Helmholtz Centre for Infection Research, Braunschweig, Germany; Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbüttel, Germany
| | - Ruibing Shi
- Biostatistics, Helmholtz Centre for Infection Research, Braunschweig, Germany
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Boknik P, Eskandar J, Hofmann B, Zimmermann N, Neumann J, Gergs U. Role of Cardiac A 2A Receptors Under Normal and Pathophysiological Conditions. Front Pharmacol 2021; 11:627838. [PMID: 33574762 PMCID: PMC7871008 DOI: 10.3389/fphar.2020.627838] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/15/2020] [Indexed: 12/12/2022] Open
Abstract
This review presents an overview of cardiac A2A-adenosine receptors The localization of A2A-AR in the various cell types that encompass the heart and the role they play in force regulation in various mammalian species are depicted. The putative signal transduction systems of A2A-AR in cells in the living heart, as well as the known interactions of A2A-AR with membrane-bound receptors, will be addressed. The possible role that the receptors play in some relevant cardiac pathologies, such as persistent or transient ischemia, hypoxia, sepsis, hypertension, cardiac hypertrophy, and arrhythmias, will be reviewed. Moreover, the cardiac utility of A2A-AR as therapeutic targets for agonistic and antagonistic drugs will be discussed. Gaps in our knowledge about the cardiac function of A2A-AR and future research needs will be identified and formulated.
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Affiliation(s)
- P. Boknik
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Westfälische Wilhelms-Universität, Münster, Germany
| | - J. Eskandar
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Westfälische Wilhelms-Universität, Münster, Germany
| | - B. Hofmann
- Cardiac Surgery, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - N. Zimmermann
- Bundesinstitut für Arzneimittel und Medizinprodukte, Bonn, Germany
| | - J. Neumann
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - U. Gergs
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
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Aljassem M, Khizaneishvili L, Noutsias M, Hofmann B, Veres G, Szabó G. Impact of BMI on Postoperative Outcome after TAVI. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Weber V, Olzscha H, Längrich T, Hartmann C, Jung M, Hofmann B, Horstkorte R, Bork K. Glycation Increases the Risk of Microbial Traversal through an Endothelial Model of the Human Blood-Brain Barrier after Use of Anesthetics. J Clin Med 2020; 9:jcm9113672. [PMID: 33207595 PMCID: PMC7698006 DOI: 10.3390/jcm9113672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 11/16/2022] Open
Abstract
The function of the human blood–brain barrier (BBB), consisting mainly of the basement membrane and microvascular endothelial cells, is to protect the brain and regulate its metabolism. Dysfunction of the BBB can lead to increased permeability, which can be linked with several pathologies, including meningitis, sepsis, and postoperative delirium. Advanced glycation end products (AGE) are non-enzymatic, posttranslational modifications of proteins, which can affect their function. Increased AGE levels are strongly associated with ageing and degenerative diseases including diabetes. Several studies demonstrated that the formation of AGE interfere with the function of the BBB and may change its permeability for soluble compounds. However, it is still unclear whether AGE can facilitate microbial traversal through the BBB and how small compounds including anesthetics modulate this process. Therefore, we developed a cellular model, which allows for the convenient testing of different factors and compounds with a direct correlation to bacterial traversal through the BBB. Our results demonstrate that both glycation and anesthetics interfere with the function of the BBB and promote microbial traversal. Importantly, we also show that the essential nutrient and antioxidant ascorbic acid, commonly known as vitamin C, can reduce the microbial traversal through the BBB and partly reverse the effects of AGE.
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Affiliation(s)
- Veronika Weber
- Institut für Physiologische Chemie, Martin-Luther-Universität Halle-Wittenberg, Hollystr. 1, 06114 Halle (Saale), Germany; (V.W.); (T.L.); (R.H.); (K.B.)
| | - Heidi Olzscha
- Institut für Physiologische Chemie, Martin-Luther-Universität Halle-Wittenberg, Hollystr. 1, 06114 Halle (Saale), Germany; (V.W.); (T.L.); (R.H.); (K.B.)
- Correspondence: ; Tel.: +49-345-557-3847
| | - Timo Längrich
- Institut für Physiologische Chemie, Martin-Luther-Universität Halle-Wittenberg, Hollystr. 1, 06114 Halle (Saale), Germany; (V.W.); (T.L.); (R.H.); (K.B.)
| | - Carla Hartmann
- Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik, Martin-Luther-Universität Halle-Wittenberg, Julius-Kühn-Str. 7, 06112 Halle (Saale), Germany; (C.H.); (M.J.)
| | - Matthias Jung
- Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik, Martin-Luther-Universität Halle-Wittenberg, Julius-Kühn-Str. 7, 06112 Halle (Saale), Germany; (C.H.); (M.J.)
| | - Britt Hofmann
- Klinik und Poliklinik für Herzchirurgie, Universitätsklinikum Halle (Saale), Ernst-Grube-Str. 20, 06120 Halle (Saale), Germany;
| | - Rüdiger Horstkorte
- Institut für Physiologische Chemie, Martin-Luther-Universität Halle-Wittenberg, Hollystr. 1, 06114 Halle (Saale), Germany; (V.W.); (T.L.); (R.H.); (K.B.)
| | - Kaya Bork
- Institut für Physiologische Chemie, Martin-Luther-Universität Halle-Wittenberg, Hollystr. 1, 06114 Halle (Saale), Germany; (V.W.); (T.L.); (R.H.); (K.B.)
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Hofmann B, Simm A. Definiert das Alter den geriatrischen Patienten? Aktuelle Kardiologie 2020. [DOI: 10.1055/a-1236-7228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
ZusammenfassungÄltere Menschen stellen einen wachsenden Anteil unserer täglich medizinisch und chirurgisch zu versorgenden Patienten dar. Allerdings definiert das kalendarische Alter alleine den älteren Patienten nur unzureichend. Vielmehr scheint das biologische Alter oder das Maß an Gebrechlichkeit entscheidend für die Charakterisierung zu sein. Auch der Prozentsatz der Menschen, die gebrechlich sind, ist in den letzten Jahrzehnten stetig gestiegen. Gebrechlichkeit oder Frailty ist ein geriatrisches Syndrom, welches durch verringerte physische und psychische Reserven zur Kompensation gekennzeichnet ist. Die beiden am häufigsten genutzten Ansätze zur Definition von Gebrechlichkeit sind der phänotypische Ansatz und der Ansatz der Defizitakkumulation. Für ältere Patienten haben sich in diesem Zusammenhang 2 Interventionspunkte in der klinischen Praxis herauskristallisiert: 1. die präinterventionelle/operative Identifizierung von Hochrisikopatienten, um sowohl die Patientenerwartungen
als auch die chirurgische Entscheidungsfindung zu steuern, und 2. periinterventionelle/operative Optimierungsstrategien für gebrechliche Patienten. Noch fehlt ein mit vertretbarem Zeitaufwand in der klinischen Praxis umsetzbarer, objektiver Goldstandard zur Analyse der Frailty.
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Affiliation(s)
- Britt Hofmann
- Mitteldeutsches Herzzentrum, Universitätsklinik und Poliklinik für Herzchirurgie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Andreas Simm
- Mitteldeutsches Herzzentrum, Universitätsklinik und Poliklinik für Herzchirurgie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
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Bartling B, Schwarzmann L, Pliquett RU, Simm A, Hofmann B. Simultaneous influence of sex and age on blood pressure difference between supine and sitting body positions. Z Gerontol Geriatr 2020; 54:597-604. [PMID: 32647989 DOI: 10.1007/s00391-020-01756-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 03/20/2020] [Accepted: 06/22/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Doctors' offices and outpatient departments typically measure blood pressure (BP) with the patient in a sitting position, whereas inpatient departments also use the supine position. As sex and age influence the autonomic function associated with BP regulation our study compared BP measurements in supine and sitting positions for men and women of different ages. METHODS We included 91 men and 118 women (≥18 years) without severe diseases. Hypertension was not an exclusion criterion because it is common in older persons. Mean left brachial BP and heart rate were determined by a digital sphygmomanometer in supine position as well as in sitting position before and after hand force measurement. RESULTS In a supine position women had slightly lower diastolic BP values than men. After sitting up, the diastolic BP increased in nearly all subjects. This increase was greater in women older than 50 years than for aged-matched men. In contrast to diastolic BP the systolic BP increased after sitting up in only two thirds of the subjects. Especially in women younger than 50 years the systolic BP often did not increase but decreased in response to postural change. The pulse pressure was mostly reduced after sitting up. This reduction was more pronounced in women than men independent of age and physical effort (i.e. hand force measurement). The sitting position also caused an increased heart rate, which was independent of sex and age. CONCLUSION Postural changes in the systolic and diastolic BP simultaneously depend on sex and age that needs to be considered for BP measurements in supine and sitting body positions.
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Affiliation(s)
- Babett Bartling
- Department of Cardiac Surgery, Mid-German Heart Centre, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany.
| | - Luisa Schwarzmann
- Department of Cardiac Surgery, Mid-German Heart Centre, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - Rainer Ullrich Pliquett
- Department for Internal Medicine II, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Department for Nephrology and Diabetology, Carl Thiem Hospital, Cottbus, Germany
| | - Andreas Simm
- Department of Cardiac Surgery, Mid-German Heart Centre, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Centre, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
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Hofmann B, Gerull KA, Bloch K, Riemer M, Erbs C, Fröhlich A, Richter S, Ehrhardt M, Zitterbart C, Bartel FF, Siegel P, Wienke A, Silber RE, Simm A. It's all in our skin-Skin autofluorescence-A promising outcome predictor in cardiac surgery: A single centre cohort study. PLoS One 2020; 15:e0234847. [PMID: 32598375 PMCID: PMC7323943 DOI: 10.1371/journal.pone.0234847] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 07/04/2019] [Accepted: 06/03/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The optimum risk score determining perioperative mortality and morbidity in cardiac surgery remains debated. Advanced glycation end products (AGEs) derived from glycaemic and oxidative stress accumulate to a comparable amount in skin and the cardiovascular system leading to a decline in organ function. We aimed to study the association between AGE accumulation measured as skin autofluorescence (sAF) and the outcome of cardiac surgery patients. METHODS Between April 2008 and November 2016, data from 758 consecutive patients undergoing coronary artery bypass grafting, aortic valve replacement or a combined procedure were analyzed. Skin autofluorescence was measured using an autofluorescence reader. Beside mortality, for the combined categorical morbidity outcome of each patient failure of the cardiac-, pulmonary-, renal- and cerebral system, as well as reoperation and wound healing disorders were counted. Patients without or with only one of the outcomes were assigned zero points whereas more than one outcome failure resulted in one point. Odds ratios (ORs) were estimated in multivariable logistic regression analysis with other preoperative parameters and the established cardiac surgery risk score systems EuroSCORE II and STS score. RESULTS Skin autofluorescence as non-invasive marker of tissue glycation provided the best prognostic value in identifying patients with major morbidity risks after cardiac surgery (OR = 3.13; 95%CI 2.16-4.54). With respect to mortality prediction the STS score (OR = 1.24; 95%CI 1.03-1.5) was superior compared to the EuroSCORE II (OR = 1.17: 95%CI 0.96-1.43), but not superior when compared to sAF (OR = 6.04; 95%CI 2.44-14.95). CONCLUSION This finding suggests that skin autofluorescence is a good biomarker candidate to assess the perioperative risk of patients in cardiac surgery. Since the EuroSCORE does not contain a morbidity component, in our view further sAF measurement is an option.
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Affiliation(s)
- Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), Halle, Germany
| | - Kristin Anja Gerull
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), Halle, Germany
| | - Katja Bloch
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), Halle, Germany
| | - Marcus Riemer
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), Halle, Germany
- Department of Gynecology, St. Elisabeth and St. Barbara Hospital Halle (Saale), Halle, Germany
| | - Christian Erbs
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), Halle, Germany
- Department of Surgery, Hospital Aarberg, Spital Netz Bern, Aarberg, Switzerland
| | - Anna Fröhlich
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), Halle, Germany
| | - Sissy Richter
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), Halle, Germany
| | - Martin Ehrhardt
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), Halle, Germany
| | - Christopher Zitterbart
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), Halle, Germany
| | - Friederike Fee Bartel
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), Halle, Germany
| | - Pauline Siegel
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), Halle, Germany
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Rolf-Edgar Silber
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), Halle, Germany
| | - Andreas Simm
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle (Saale), Halle, Germany
- * E-mail:
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Westerhausen M, Metzger M, Blendinger F, Levermann A, Fleischer M, Hofmann B, Bucher V. Characterization of Biostable Atomic Layer Deposited (ALD) Multilayer Passivation Coatings for Active Implants .. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:3927-3930. [PMID: 31946731 DOI: 10.1109/embc.2019.8856574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The next generation of flexible, electrically active implants, such as brain implants or retina chips require a flexible, biostable as well as biocompatible passivation, ensuring a degradation-free usage for long time periods on the order of several years. Until today, these passivations are prepared mostly by polyimides or parylene, both of which are water vapor permeable to a certain degree. To remedy this deficiency, Atomic Layer Deposited (ALD) thin films are characterized regarding their electrical passivating features under conditions of accelerated aging, such as elevated temperatures in a liquid environment. The initial electrical passivation by various ALD deposited multilayers, combining alternating thin Al2O3 and TiO2 layers is the goal of this research as well as the stability of these layers under induced degradation. Such layers, in combination with a parylene passivation, would ensure a water vapor impermeable and biocompatible coating.
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Silaschi M, Eckert L, Hofmann B, Oezkur M, Charitos E, Sedding D, Treede H. Durability of Transcatheter Aortic Valves Beyond 5 Years: A Retrospective Single-Center Analysis. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Adermann L, Hofmann B, Khizaneishvili L, Oezkur M, Sedding D, Wilbring M, Treede H, Silaschi M. Long-Term Pacemaker Dependency after Permanent Pacemaker Implantation Secondary to Heart Valve Surgery. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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