1
|
Derendorf L, Stock S, Simic D, Shukri A, Zelenak C, Nagel J, Friede T, Herbeck Belnap B, Herrmann-Lingen C, Pedersen SS, Sørensen J, Müller And On Behalf Of The Escape Consortium D. Health economic evaluation of blended collaborative care for older multimorbid heart failure patients: study protocol. Cost Eff Resour Alloc 2024; 22:29. [PMID: 38615050 PMCID: PMC11015692 DOI: 10.1186/s12962-024-00535-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/21/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Integrated care, in particular the 'Blended Collaborative Care (BCC)' strategy, may have the potential to improve health-related quality of life (HRQoL) in multimorbid patients with heart failure (HF) and psychosocial burden at no or low additional cost. The ESCAPE trial is a randomised controlled trial for the evaluation of a BCC approach in five European countries. For the economic evaluation of alongside this trial, the four main objectives were: (i) to document the costs of delivering the intervention, (ii) to assess the running costs across study sites, (iii) to evaluate short-term cost-effectiveness and cost-utility compared to providers' usual care, and (iv) to examine the budgetary implications. METHODS The trial-based economic analyses will include cross-country cost-effectiveness and cost-utility assessments from a payer perspective. The cost-utility analysis will calculate quality-adjusted life years (QALYs) using the EQ-5D-5L and national value sets. Cost-effectiveness will include the cost per hospital admission avoided and the cost per depression-free days (DFD). Resource use will be measured from different sources, including electronic medical health records, standardised questionnaires, patient receipts and a care manager survey. Uncertainty will be addressed using bootstrapping. DISCUSSION The various methods and approaches used for data acquisition should provide insights into the potential benefits and cost-effectiveness of a BCC intervention. Providing the economic evaluation of ESCAPE will contribute to a country-based structural and organisational planning of BCC (e.g., the number of patients that may benefit, how many care managers are needed). Improved care is expected to enhance health-related quality of life at little or no extra cost. TRIAL REGISTRATION The study follows CHEERS2022 and is registered at the German Clinical Trials Register (DRKS00025120).
Collapse
Affiliation(s)
- Lisa Derendorf
- Faculty of Medicine and University Hospital of Cologne, Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany.
| | - Stephanie Stock
- Faculty of Medicine and University Hospital of Cologne, Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany
| | - Dusan Simic
- Faculty of Medicine and University Hospital of Cologne, Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany
| | - Arim Shukri
- Faculty of Medicine and University Hospital of Cologne, Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany
| | - Christine Zelenak
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
| | - Jonas Nagel
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
| | - Tim Friede
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
- Department of Medical Statistics, University Medical Centre Göttingen, Göttingen, Germany
| | - Birgit Herbeck Belnap
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
- Center for Behavioral Health, Media, and Technology, Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Susanne S Pedersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Jan Sørensen
- Healthcare Outcomes Research Centre, Dublin, Ireland
| | | |
Collapse
|
2
|
Zelenak C, Nagel J, Bersch K, Derendorf L, Doyle F, Friede T, Herbeck Belnap B, Kohlmann S, Skou ST, Velasco CA, Albus C, Asendorf T, Bang CA, Beresnevaite M, Bruun NE, Burg MM, Buhl SF, Gæde PH, Lühmann D, Markser A, Nagy KV, Rafanelli C, Rasmussen S, Søndergaard J, Sørensen J, Stauder A, Stock S, Urbinati S, Riva DD, Wachter R, Walker F, Pedersen SS, Herrmann‐Lingen C. Integrated care for older multimorbid heart failure patients: protocol for the ESCAPE randomized trial and cohort study. ESC Heart Fail 2023; 10:2051-2065. [PMID: 36907651 PMCID: PMC10192276 DOI: 10.1002/ehf2.14294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/02/2022] [Accepted: 01/09/2023] [Indexed: 03/13/2023] Open
Abstract
ESCAPE Evaluation of a patient-centred biopsychosocial blended collaborative care pathway for the treatment of multimorbid elderly patients. THERAPEUTIC AREA Healthcare interventions for the management of older patients with multiple morbidities. AIMS Multi-morbidity treatment is an increasing challenge for healthcare systems in ageing societies. This comprehensive cohort study with embedded randomized controlled trial tests an integrated biopsychosocial care model for multimorbid elderly patients. HYPOTHESIS A holistic, patient-centred pro-active 9-month intervention based on the blended collaborative care (BCC) approach and enhanced by information and communication technologies can improve health-related quality of life (HRQoL) and disease outcomes as compared with usual care at 9 months. METHODS Across six European countries, ESCAPE is recruiting patients with heart failure, mental distress/disorder plus ≥2 medical co-morbidities into an observational cohort study. Within the cohort study, 300 patients will be included in a randomized controlled assessor-blinded two-arm parallel group interventional clinical trial (RCT). In the intervention, trained care managers (CMs) regularly support patients and informal carers in managing their multiple health problems. Supervised by a clinical specialist team, CMs remotely support patients in implementing the treatment plan-customized to the patients' individual needs and preferences-into their daily lives and liaise with patients' healthcare providers. An eHealth platform with an integrated patient registry guides the intervention and helps to empower patients and informal carers. HRQoL measured with the EQ-5D-5L as primary endpoint, and secondary outcomes, that is, medical and patient-reported outcomes, healthcare costs, cost-effectiveness, and informal carer burden, will be assessed at 9 and ≥18 months. CONCLUSIONS If proven effective, the ESCAPE BCC intervention can be implemented in routine care for older patients with multiple morbidities across the participating countries and beyond.
Collapse
Affiliation(s)
- Christine Zelenak
- Department of Psychosomatic Medicine and PsychotherapyUniversity of Göttingen Medical CentreGöttingenGermany
| | - Jonas Nagel
- Department of Psychosomatic Medicine and PsychotherapyUniversity of Göttingen Medical CentreGöttingenGermany
| | - Kristina Bersch
- Clinical Trial Unit of the University Medical Center GöttingenGöttingenGermany
| | - Lisa Derendorf
- Faculty of Medicine and University Hospital of Cologne, Institute of Health Economics and Clinical EpidemiologyUniversity of CologneCologneGermany
| | - Frank Doyle
- Royal College of Surgeons in IrelandDublinIreland
| | - Tim Friede
- Department of Medical StatisticsUniversity of Göttingen Medical CentreGöttingenGermany
- German Centre for Cardiovascular Research (DZHK), partner site GöttingenGöttingenGermany
| | - Birgit Herbeck Belnap
- Department of Psychosomatic Medicine and PsychotherapyUniversity of Göttingen Medical CentreGöttingenGermany
- Center for Behavioral Health, Media, and Technology, Division of General Internal MedicineUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Sebastian Kohlmann
- Clinic for Psychosomatic Medicine and PsychotherapyUniversity Hospital Hamburg EppendorfHamburgGermany
| | - Søren T. Skou
- The Research Unit PROgrez, Department of Physiotherapy and Occupational TherapyNæstved‐Slagelse‐Ringsted Hospitals, Region ZealandSlagelseDenmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical BiomechanicsUniversity of Southern DenmarkOdenseDenmark
| | - Carlos A. Velasco
- Fraunhofer Institute for Applied Information Technology FITSchloss BirlinghovenSankt AugustinGermany
| | - Christian Albus
- Faculty of Medicine and University Hospital of Cologne, Department of Psychosomatics and PsychotherapyUniversity of CologneCologneGermany
| | - Thomas Asendorf
- Clinical Trial Unit of the University Medical Center GöttingenGöttingenGermany
| | | | - Margarita Beresnevaite
- Laboratory of Clinical Cardiology, Institute of CardiologyLithuanian University of Health SciencesKaunasLithuania
| | - Niels Eske Bruun
- Department of CardiologyZealand University HospitalRoskildeDenmark
- Clinical InstitutesCopenhagen and Aalborg UniversitiesCopenhagenDenmark
| | | | - Sussi Friis Buhl
- Research Unit of General Practice, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
| | - Peter H. Gæde
- Department of Cardiology and EndocrinologySlagelse HospitalSlagelseDenmark
- Institute of Regional HealthUniversity of Southern DenmarkOdenseDenmark
| | | | - Anna Markser
- Faculty of Medicine and University Hospital of Cologne, Department of Psychosomatics and PsychotherapyUniversity of CologneCologneGermany
| | | | | | - Sanne Rasmussen
- Research Unit of General Practice, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
| | - Jan Sørensen
- Healthcare Outcomes Research CentreDublinIreland
| | - Adrienne Stauder
- Institute of Behavioural SciencesSemmelweis UniversityBudapestHungary
| | - Stephanie Stock
- Faculty of Medicine and University Hospital of Cologne, Institute of Health Economics and Clinical EpidemiologyUniversity of CologneCologneGermany
| | | | | | | | - Florian Walker
- Clinical Trial Unit of the University Medical Center GöttingenGöttingenGermany
| | - Susanne S. Pedersen
- Department of PsychologyUniversity of Southern DenmarkOdenseDenmark
- Department of CardiologyOdense University HospitalOdenseDenmark
| | - Christoph Herrmann‐Lingen
- Department of Psychosomatic Medicine and PsychotherapyUniversity of Göttingen Medical CentreGöttingenGermany
- German Centre for Cardiovascular Research (DZHK), partner site GöttingenGöttingenGermany
| | | |
Collapse
|
3
|
Zelenak C, Chavanon ML, Tahirovic E, Trippel TD, Tscholl V, Stroux A, Veskovic J, Apostolovic S, Obradovic D, Zdravkovic M, Loncar G, Störk S, Herrmann-Lingen C, Düngen HD. Early NT-proBNP and MR-proANP associated with QoL 1 year after acutely decompensated heart failure: secondary analysis from the MOLITOR trial. Biomark Med 2019; 13:1493-1507. [PMID: 31659915 DOI: 10.2217/bmm-2019-0083] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aim: Heart failure negatively impacts quality of life (QoL), which in turn contributes to an adverse long-term prognosis. We aimed at identifying biomarker trajectories after an episode of acutely decompensated heart failure (ADHF) that differ between patients showing average versus impaired QoL 1 year later, thus allowing to predict impaired QoL. Methods: Biomarkers were repeatedly measured throughout the year in 104 ADHF patients. QoL was assessed at discharge and 1 year after ADHF. Logistic regression and receiver operating characteristic analyses were used to identify predictors of impaired QoL while controlling psychosocial confounders. Results: MR-proANP predicted impaired physical and mental QoL. NT-proBNP measurements were important predictors for poor physical QoL. Conclusion: MR-proANP and NT-proBNP predict poor QoL after an epidode of ADHF. The trial is registered at http://clinicaltrials.gov as MOLITOR (IMpact of therapy optimisation On the Level of biomarkers in paTients with Acute and Decompensated ChrOnic HeaRt Failure) with unique identifier: NCT01501981.
Collapse
Affiliation(s)
- Christine Zelenak
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, Berlin, Germany
| | - Mira-Lynn Chavanon
- Department of Psychology, Philipps Universität Marburg, Marburg, Germany
| | - Elvis Tahirovic
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Tobias Daniel Trippel
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Verena Tscholl
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, Berlin, Germany
| | - Andrea Stroux
- Department for Biometry & Clinical Epidemiology, CBF, Charité University Medicine Berlin, Berlin, Germany
| | - Jovan Veskovic
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Svetlana Apostolovic
- Department for Cardiovascular Diseases, Clinical Centre Niš, University of Niš, Niš, Serbia
| | - Danilo Obradovic
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, Berlin, Germany
| | - Marija Zdravkovic
- Department of Cardiology, University Clinical Hospital Center Bezanijska Kosa, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Goran Loncar
- Institute for Cardiovascular Diseases Dedinje, Department of Cardioloy, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Stefan Störk
- Comprehensive Heart Failure Center, University Hospital Würzburg, Germany.,Department of Medicine I, University Hospital Würzburg, Germany
| | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine & Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Hans-Dirk Düngen
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| |
Collapse
|
4
|
Wolk K, Wenzel J, Tsaousi A, Witte-Händel E, Babel N, Zelenak C, Volk HD, Sterry W, Schneider-Burrus S, Sabat R. Lipocalin-2 is expressed by activated granulocytes and keratinocytes in affected skin and reflects disease activity in acne inversa/hidradenitis suppurativa. Br J Dermatol 2017; 177:1385-1393. [PMID: 28256718 DOI: 10.1111/bjd.15424] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Acne inversa (AI)/hidradenitis suppurativa is a chronic inflammatory disease characterized by painful axillary, inguinal and perianal skin lesions with deep-seated nodules, abscesses and fistulae. OBJECTIVES This study aimed to identify and characterize the key players in AI pathogenesis. METHODS Epidemiological and anamnestic data for patients with AI were collected, and blood and skin samples were also taken. Healthy participants and patients with psoriasis served as controls. Assessment of samples and cultures of primary cells was performed by enzyme-linked immunosorbent assay, quantitative polymerase chain reaction on reverse transcribed mRNA, and immunohistochemistry. RESULTS Of 35 mediators quantified in the blood of patients with AI, lipocalin-2 (LCN2) appeared as one of the most significantly upregulated parameters compared with healthy participants [85·8 ± 12·2 (n = 18) vs. 41·8 ± 4·2 (n = 15); P < 0·001]. Strongly elevated LCN2 expression was present in AI lesions, with granulocytes and keratinocytes being sources of this expression. In vitro, these cells upregulated LCN2 production in response to tumour necrosis factor (TNF)-α, and a positive relationship between systemic TNF-α and LCN2 levels (rs = 0·55, P = 0·011; n = 20) was evident for AI. LCN2 blood levels correlated with AI disease severity (rs = 0·65, P < 0·001; n = 29), but not with disease duration, age, sex, body mass index or smoking habit. Detailed analyses revealed a link with the number of skin regions containing nodules and fistulae, but not scars. CONCLUSIONS LCN2 might serve as a blood biomarker for the objective assessment of inflammatory activity in AI. We suggest a self-amplification loop comprising TNF-α, neutrophilic granulocytes and LCN2, which contributes to the recurrent skin neutrophil infiltration in AI, clinically evident as pus.
Collapse
Affiliation(s)
- K Wolk
- Interdisciplinary Group of Molecular Immunopathology, Charité University Medicine, Berlin, Germany.,Psoriasis Research and Treatment Centre, Dermatology/Medical Immunology, Charité University Medicine, Berlin, Germany.,Berlin-Brandenburg Centre for Regenerative Therapies, Charité University Medicine, Berlin, Germany
| | - J Wenzel
- Department of Dermatology and Allergy, University of Bonn, Bonn, Germany
| | - A Tsaousi
- Psoriasis Research and Treatment Centre, Dermatology/Medical Immunology, Charité University Medicine, Berlin, Germany
| | - E Witte-Händel
- Interdisciplinary Group of Molecular Immunopathology, Charité University Medicine, Berlin, Germany.,Psoriasis Research and Treatment Centre, Dermatology/Medical Immunology, Charité University Medicine, Berlin, Germany
| | - N Babel
- Institute of Medical Immunology, Charité University Medicine, Berlin, Germany
| | - C Zelenak
- Interdisciplinary Group of Molecular Immunopathology, Charité University Medicine, Berlin, Germany
| | - H-D Volk
- Berlin-Brandenburg Centre for Regenerative Therapies, Charité University Medicine, Berlin, Germany.,Institute of Medical Immunology, Charité University Medicine, Berlin, Germany
| | - W Sterry
- Department of Dermatology and Allergy, Charité University Medicine, Berlin, Germany
| | - S Schneider-Burrus
- Department of Dermatology and Allergy, Charité University Medicine, Berlin, Germany
| | - R Sabat
- Interdisciplinary Group of Molecular Immunopathology, Charité University Medicine, Berlin, Germany.,Psoriasis Research and Treatment Centre, Dermatology/Medical Immunology, Charité University Medicine, Berlin, Germany.,Research Centre Immunosciences, Charité University Medicine, Berlin, Germany
| |
Collapse
|
5
|
Weisrock F, Fritschka M, Beckmann S, Litmeier S, Wagner J, Tahirovic E, Radenovic S, Zelenak C, Hashemi D, Busjahn A, Krahn T, Pieske B, Dinh W, Düngen HD. Reliability of peripheral arterial tonometry in patients with heart failure, diabetic nephropathy and arterial hypertension. Vasc Med 2017; 22:292-300. [PMID: 28555533 DOI: 10.1177/1358863x17706752] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Endothelial dysfunction plays a major role in cardiovascular diseases and pulse amplitude tonometry (PAT) offers a non-invasive way to assess endothelial dysfunction. However, data about the reliability of PAT in cardiovascular patient populations are scarce. Thus, we evaluated the test-retest reliability of PAT using the natural logarithmic transformed reactive hyperaemia index (LnRHI). Our cohort consisted of 91 patients (mean age: 65±9.7 years, 32% female), who were divided into four groups: those with heart failure with preserved ejection fraction (HFpEF) ( n=25), heart failure with reduced ejection fraction (HFrEF) ( n=22), diabetic nephropathy ( n=21), and arterial hypertension ( n=23). All subjects underwent two separate PAT measurements at a median interval of 7 days (range 4-14 days). LnRHI derived by PAT showed good reliability in subjects with diabetic nephropathy (intra-class correlation (ICC) = 0.863) and satisfactory reliability in patients with both HFpEF (ICC = 0.557) and HFrEF (ICC = 0.576). However, in subjects with arterial hypertension, reliability was poor (ICC = 0.125). We demonstrated that PAT is a reliable technique to assess endothelial dysfunction in adults with diabetic nephropathy, HFpEF or HFrEF. However, in subjects with arterial hypertension, we did not find sufficient reliability, which can possibly be attributed to variations in heart rate and the respective time of the assessments. Clinical Trial Registration Identifier: NCT02299960.
Collapse
Affiliation(s)
- Fabian Weisrock
- 1 Department of Cardiology, Charité Universitätsmedizin, Campus Virchow-Klinikum, Berlin, Germany
| | - Max Fritschka
- 2 Department of Internal Medicine - Cardiology, Deutsches Herzzentrum Berlin, Germany
| | - Sebastian Beckmann
- 1 Department of Cardiology, Charité Universitätsmedizin, Campus Virchow-Klinikum, Berlin, Germany
| | - Simon Litmeier
- 1 Department of Cardiology, Charité Universitätsmedizin, Campus Virchow-Klinikum, Berlin, Germany
| | - Josephine Wagner
- 1 Department of Cardiology, Charité Universitätsmedizin, Campus Virchow-Klinikum, Berlin, Germany
| | - Elvis Tahirovic
- 1 Department of Cardiology, Charité Universitätsmedizin, Campus Virchow-Klinikum, Berlin, Germany
| | - Sara Radenovic
- 1 Department of Cardiology, Charité Universitätsmedizin, Campus Virchow-Klinikum, Berlin, Germany
| | - Christine Zelenak
- 1 Department of Cardiology, Charité Universitätsmedizin, Campus Virchow-Klinikum, Berlin, Germany
| | - Djawid Hashemi
- 1 Department of Cardiology, Charité Universitätsmedizin, Campus Virchow-Klinikum, Berlin, Germany.,3 DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
| | | | - Thomas Krahn
- 5 Department Head Global Biomarker Research, BAYER Pharma AG, Wuppertal, Germany
| | - Burkert Pieske
- 1 Department of Cardiology, Charité Universitätsmedizin, Campus Virchow-Klinikum, Berlin, Germany.,2 Department of Internal Medicine - Cardiology, Deutsches Herzzentrum Berlin, Germany.,3 DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
| | - Wilfried Dinh
- 6 Bayer AG, Drug Discovery, Clinical Sciences- Experimental Medicine, Wuppertal, Germany.,7 Department of Cardiology, HELIOS Clinic Wuppertal, University Hospital Witten/Herdecke, Germany
| | - Hans-Dirk Düngen
- 1 Department of Cardiology, Charité Universitätsmedizin, Campus Virchow-Klinikum, Berlin, Germany
| |
Collapse
|
6
|
Zelenak C, Radenovic S, Musial-Bright L, Tahirovic E, Sacirovic M, Lee CB, Jahandar-Lashki D, Inkrot S, Trippel TD, Busjahn A, Hashemi D, Wachter R, Pankuweit S, Störk S, Pieske B, Edelmann F, Düngen HD. Heart failure awareness survey in Germany: general knowledge on heart failure remains poor. ESC Heart Fail 2017; 4:224-231. [PMID: 28772053 PMCID: PMC5542724 DOI: 10.1002/ehf2.12144] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 12/06/2016] [Revised: 01/19/2017] [Accepted: 02/10/2017] [Indexed: 11/18/2022] Open
Abstract
Aims Previous studies demonstrated poor public awareness of heart failure (HF) compared with myocardial infarction and stroke. With respect to several activities to improve HF awareness in recent years, we present data on the development of HF awareness and information sources in Germany over 8 years. Methods and results In 2007, 2012, and 2015, respectively, 2531, 359, and 171 respondents answered questions about causes, presentation, prognosis, and treatment of HF from a survey developed by the German Competence Network HF. Relationships between respondents' sociodemographic data and their HF knowledge were explored and changes in knowledge and use of information sources analysed. Sixty‐eight per cent of respondents knew HF as ‘weakness of the heart’. Seventy‐nine per cent knew shortness of breath, 74% reduced exercise tolerance, and 52% knew leg edema as symptoms. Only 40% knew all three symptoms. Although up to 34% of the respondents were directly or indirectly affected by HF, they demonstrated poor knowledge about severity and prognosis. Between 2007 and 2015, overall HF awareness has not changed; awareness about treatment has dropped significantly. Younger respondents used all media, especially internet, for information about health; older respondents preferred printed/verbal media and their physician. Conclusions We found rather insufficient public knowledge on HF etiology and symptoms but especially about management, severity, and prognosis, which is essential for good self‐care and adherence of patients. Heart failure awareness has not improved even though awareness campaigns were held over the years. It seems that especially older patients should be much more approached by their family physicians.
Collapse
Affiliation(s)
- Christine Zelenak
- Department of Internal Medicine-Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin-Campus Virchow Klinikum, Berlin, Germany
| | - Sara Radenovic
- Department of Internal Medicine-Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin-Campus Virchow Klinikum, Berlin, Germany
| | - Lindy Musial-Bright
- Department of Internal Medicine-Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin-Campus Virchow Klinikum, Berlin, Germany
| | - Elvis Tahirovic
- Department of Internal Medicine-Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin-Campus Virchow Klinikum, Berlin, Germany
| | - Mesud Sacirovic
- Department of Internal Medicine-Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin-Campus Virchow Klinikum, Berlin, Germany
| | - Chong-Bin Lee
- Department of Internal Medicine-Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin-Campus Virchow Klinikum, Berlin, Germany
| | - Diana Jahandar-Lashki
- Department of Internal Medicine-Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin-Campus Virchow Klinikum, Berlin, Germany
| | - Simone Inkrot
- Department of Cardiology, Waikato Hospital, Hamilton, New Zealand
| | - Tobias Daniel Trippel
- Department of Internal Medicine-Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin-Campus Virchow Klinikum, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | | | - Djawid Hashemi
- Department of Internal Medicine-Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin-Campus Virchow Klinikum, Berlin, Germany
| | - Rolf Wachter
- Clinic for Cardiology and Pneumology, University of Göttingen, and DZHK (German Centre for Cardiovascular Research), Partner Site Göttingen, Berlin, Germany
| | - Sabine Pankuweit
- Department of Cardiology, University Hospital of Giessen and Marburg, Marburg, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center, University of Würzburg and Department of Medicine I, Würzburg, Germany
| | - Burkert Pieske
- Department of Internal Medicine-Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin-Campus Virchow Klinikum, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Frank Edelmann
- Department of Internal Medicine-Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin-Campus Virchow Klinikum, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Hans-Dirk Düngen
- Department of Internal Medicine-Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin-Campus Virchow Klinikum, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| |
Collapse
|
7
|
Bissinger R, Lang E, Ghashghaeinia M, Singh Y, Zelenak C, Fehrenbacher B, Honisch S, Chen H, Fakhri H, Umbach AT, Liu G, Rexhepaj R, Liu G, Schaller M, Mack AF, Lupescu A, Birnbaumer L, Lang F, Qadri SM. Blunted apoptosis of erythrocytes in mice deficient in the heterotrimeric G-protein subunit Gαi2. Sci Rep 2016; 6:30925. [PMID: 27499046 PMCID: PMC4976336 DOI: 10.1038/srep30925] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 01/15/2016] [Accepted: 07/11/2016] [Indexed: 01/09/2023] Open
Abstract
Putative functions of the heterotrimeric G-protein subunit Gαi2-dependent signaling include ion channel regulation, cell differentiation, proliferation and apoptosis. Erythrocytes may, similar to apoptosis of nucleated cells, undergo eryptosis, characterized by cell shrinkage and cell membrane scrambling with phosphatidylserine (PS) exposure. Eryptosis may be triggered by increased cytosolic Ca2+ activity and ceramide. In the present study, we show that Gαi2 is expressed in both murine and human erythrocytes and further examined the survival of erythrocytes drawn from Gαi2-deficient mice (Gαi2−/−) and corresponding wild-type mice (Gαi2+/+). Our data show that plasma erythropoietin levels, erythrocyte maturation markers, erythrocyte counts, hematocrit and hemoglobin concentration were similar in Gαi2−/− and Gαi2+/+ mice but the mean corpuscular volume was significantly larger in Gαi2−/− mice. Spontaneous PS exposure of circulating Gαi2−/− erythrocytes was significantly lower than that of circulating Gαi2+/+ erythrocytes. PS exposure was significantly lower in Gαi2−/− than in Gαi2+/+ erythrocytes following ex vivo exposure to hyperosmotic shock, bacterial sphingomyelinase or C6 ceramide. Erythrocyte Gαi2 deficiency further attenuated hyperosmotic shock-induced increase of cytosolic Ca2+ activity and cell shrinkage. Moreover, Gαi2−/− erythrocytes were more resistant to osmosensitive hemolysis as compared to Gαi2+/+ erythrocytes. In conclusion, Gαi2 deficiency in erythrocytes confers partial protection against suicidal cell death.
Collapse
Affiliation(s)
- Rosi Bissinger
- Institute of Cardiology, Vascular Medicine and Physiology, University of Tuebingen, Germany
| | - Elisabeth Lang
- Department of Gastroenterology, Hepatology and Infectious Diseases, University of Duesseldorf, Germany
| | - Mehrdad Ghashghaeinia
- Institute of Cardiology, Vascular Medicine and Physiology, University of Tuebingen, Germany
| | - Yogesh Singh
- Institute of Cardiology, Vascular Medicine and Physiology, University of Tuebingen, Germany
| | - Christine Zelenak
- Department of Internal Medicine, Charité Medical University, Berlin, Germany
| | | | - Sabina Honisch
- Institute of Cardiology, Vascular Medicine and Physiology, University of Tuebingen, Germany
| | - Hong Chen
- Institute of Cardiology, Vascular Medicine and Physiology, University of Tuebingen, Germany
| | - Hajar Fakhri
- Institute of Cardiology, Vascular Medicine and Physiology, University of Tuebingen, Germany
| | - Anja T Umbach
- Institute of Cardiology, Vascular Medicine and Physiology, University of Tuebingen, Germany
| | - Guilai Liu
- Institute of Cardiology, Vascular Medicine and Physiology, University of Tuebingen, Germany
| | - Rexhep Rexhepaj
- Institute of Cardiology, Vascular Medicine and Physiology, University of Tuebingen, Germany.,Institute of Biochemistry and Molecular Biology, University of Bonn, Germany
| | - Guoxing Liu
- Institute of Cardiology, Vascular Medicine and Physiology, University of Tuebingen, Germany
| | | | | | - Adrian Lupescu
- Institute of Cardiology, Vascular Medicine and Physiology, University of Tuebingen, Germany
| | - Lutz Birnbaumer
- Neurobiology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Florian Lang
- Institute of Cardiology, Vascular Medicine and Physiology, University of Tuebingen, Germany
| | - Syed M Qadri
- Institute of Cardiology, Vascular Medicine and Physiology, University of Tuebingen, Germany.,Institute of Biomedical Research (BIOMED), School of Medical Sciences, Catholic University of Argentina, Buenos Aires, Argentina.,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
8
|
Jahandar Lashki D, Zelenak C, Tahirovic E, Trippel TD, Kolip P, Busjahn A, Rauchfuß M, Nolte K, Schwarz S, Wachter R, Gelbrich G, Halle M, Pieske B, Herrmann-Lingen C, Edelmann F, Düngen HD. [Assessment of subjective physical well-being in heart failure : Validation of the FEW16 questionnaire]. Herz 2016; 42:200-208. [PMID: 27412664 DOI: 10.1007/s00059-016-4458-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/15/2016] [Accepted: 06/17/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Improvement in the quality of life (QoL) is a major goal of therapy for heart failure (HF) patients. Physical well-being as an important component of QoL has not yet been sufficiently covered by disease-specific assessment instruments. The aim of the study was to validate the questionnaire for assessing subjective physical well-being (FEW16) in HF patients with preserved ejection fraction (HFpEF) from the exercise training in diastolic heart failure (Ex-DHF‑P) trial. METHOD A total of 64 HFpEF patients (65 years, 56 % female) were randomized to usual routine treatment with (n = 44) or without training (n = 20). At baseline and 3 months, patients were clinically evaluated and assessed using appropriate questionnaires on the QoL (SF36), physical well-being (FEW16) and depression (PHQ-D). RESULTS The FEW16 showed good values for Cronbachs' alpha coefficients (0.85-0.93). The cross-validity with SF36 and PHQ-D was highly significant but more so for psychological aspects. At baseline, the FEW16 score correlated with age, the subscale resilience with age and the 6 min walking distance test. At follow-up, the total and resilience scores had improved in the training group. In contrast to the SF36, the FEW16 did not detect differences between the groups in Ex-DHF‑P. DISCUSSION The FEW16 questionnaire showed good internal consistency and correlation with SF36, its total score and resilience had improved after training; however, it did not reflect different changes between the study groups. The FEW16 is therefore more suited to assess general/mental well-being than the subjective physical well-being.
Collapse
Affiliation(s)
- D Jahandar Lashki
- Klinik für Innere Medizin - Kardiologie, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - C Zelenak
- Klinik für Innere Medizin - Kardiologie, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - E Tahirovic
- Klinik für Innere Medizin - Kardiologie, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - T D Trippel
- Klinik für Innere Medizin - Kardiologie, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.,Standort Berlin, Deutsches Zentrum für Herz-Kreislauf-Forschung, Berlin, Deutschland
| | - P Kolip
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld, Deutschland
| | - A Busjahn
- HealthTwiSt GmbH, Berlin, Deutschland
| | - M Rauchfuß
- Medizinische Klinik m. S. Psychosomatik, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - K Nolte
- Klinik für Kardiologie und Pneumologie, Herzzentrum Göttingen, Universität Göttingen, Göttingen, Deutschland
| | - S Schwarz
- Zentrum für Prävention und Sportmedizin, Munich Heart Alliance, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
| | - R Wachter
- Standort Göttingen, Deutsches Zentrum für Herz-Kreislauf-Forschung, Göttingen, Deutschland.,Klinik für Kardiologie und Pneumologie, Herzzentrum Göttingen, Universität Göttingen, Göttingen, Deutschland
| | - G Gelbrich
- Institut für Klinische Epidemiologie und Biometrie, Universität Würzburg, Würzburg, Deutschland
| | - M Halle
- Zentrum für Prävention und Sportmedizin, Munich Heart Alliance, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
| | - B Pieske
- Klinik für Innere Medizin - Kardiologie, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - C Herrmann-Lingen
- Klinik für Psychosomatische Medizin und Psychotherapie, Universität Göttingen, Göttingen, Deutschland.,Standort Göttingen, Deutsches Zentrum für Herz-Kreislauf-Forschung, Göttingen, Deutschland
| | - F Edelmann
- Klinik für Innere Medizin - Kardiologie, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - H-D Düngen
- Klinik für Innere Medizin - Kardiologie, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
| |
Collapse
|
9
|
Lang E, Bissinger R, Fajol A, Salker MS, Singh Y, Zelenak C, Ghashghaeinia M, Gu S, Jilani K, Lupescu A, Reyskens KMSE, Ackermann TF, Föller M, Schleicher E, Sheffield WP, Arthur JSC, Lang F, Qadri SM. Accelerated apoptotic death and in vivo turnover of erythrocytes in mice lacking functional mitogen- and stress-activated kinase MSK1/2. Sci Rep 2015; 5:17316. [PMID: 26611568 PMCID: PMC4661433 DOI: 10.1038/srep17316] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [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: 03/11/2015] [Accepted: 10/28/2015] [Indexed: 12/25/2022] Open
Abstract
The mitogen- and stress-activated kinase MSK1/2 plays a decisive role in apoptosis. In analogy to apoptosis of nucleated cells, suicidal erythrocyte death called eryptosis is characterized by cell shrinkage and cell membrane scrambling leading to phosphatidylserine (PS) externalization. Here, we explored whether MSK1/2 participates in the regulation of eryptosis. To this end, erythrocytes were isolated from mice lacking functional MSK1/2 (msk−/−) and corresponding wild-type mice (msk+/+). Blood count, hematocrit, hemoglobin concentration and mean erythrocyte volume were similar in both msk−/− and msk+/+ mice, but reticulocyte count was significantly increased in msk−/− mice. Cell membrane PS exposure was similar in untreated msk−/− and msk+/+ erythrocytes, but was enhanced by pathophysiological cell stressors ex vivo such as hyperosmotic shock or energy depletion to significantly higher levels in msk−/− erythrocytes than in msk+/+ erythrocytes. Cell shrinkage following hyperosmotic shock and energy depletion, as well as hemolysis following decrease of extracellular osmolarity was more pronounced in msk−/− erythrocytes. The in vivo clearance of autologously-infused CFSE-labeled erythrocytes from circulating blood was faster in msk−/− mice. The spleens from msk−/− mice contained a significantly greater number of PS-exposing erythrocytes than spleens from msk+/+ mice. The present observations point to accelerated eryptosis and subsequent clearance of erythrocytes leading to enhanced erythrocyte turnover in MSK1/2-deficient mice.
Collapse
Affiliation(s)
- Elisabeth Lang
- Department of Physiology, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany.,Department of Gastroenterology, Hepatology and Infectious Diseases, University of Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany
| | - Rosi Bissinger
- Department of Physiology, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany
| | - Abul Fajol
- Department of Physiology, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany
| | - Madhuri S Salker
- Department of Physiology, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany
| | - Yogesh Singh
- Department of Physiology, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany
| | - Christine Zelenak
- Charité Medical University Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Mehrdad Ghashghaeinia
- Department of Physiology, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany
| | - Shuchen Gu
- Department of Physiology, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany.,Life Sciences Institute, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Kashif Jilani
- Department of Physiology, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany.,Department of Biochemistry, University of Agriculture, 38040 Faisalabad, Pakistan
| | - Adrian Lupescu
- Department of Physiology, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany
| | - Kathleen M S E Reyskens
- MRC Phosphorylation Unit, University of Dundee, Dow Street, Dundee DD1 5EH, United Kingdom.,Division of Cell Signaling and Immunology, College of Life Sciences, University of Dundee, Dow Street, Dundee DD1 5EH, United Kingdom
| | - Teresa F Ackermann
- Department of Physiology, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany
| | - Michael Föller
- Department of Physiology, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany.,nstitute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Von-Danckelmann-Platz 2, 06120 Halle (Saale), Germany
| | - Erwin Schleicher
- Department of Internal Medicine, University of Tübingen, Otfried-Müller-Straβe 10, 72076 Tübingen, Germany
| | - William P Sheffield
- Department of Pathology and Molecular Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S4K1, Canada.,Centre for Innovation, Canadian Blood Services, 1280 Main Street West, Hamilton, Ontario L8S4K1, Canada
| | - J Simon C Arthur
- MRC Phosphorylation Unit, University of Dundee, Dow Street, Dundee DD1 5EH, United Kingdom.,Division of Cell Signaling and Immunology, College of Life Sciences, University of Dundee, Dow Street, Dundee DD1 5EH, United Kingdom
| | - Florian Lang
- Department of Physiology, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany
| | - Syed M Qadri
- Department of Physiology, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany.,Department of Pathology and Molecular Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S4K1, Canada.,Centre for Innovation, Canadian Blood Services, 1280 Main Street West, Hamilton, Ontario L8S4K1, Canada
| |
Collapse
|
10
|
Lang E, Zelenak C, Eberhard M, Bissinger R, Rotte A, Ghashghaeinia M, Lupescu A, Lang F, Qadri SM. Impact of Cyclin-Dependent Kinase CDK4 Inhibition on Eryptosis. Cell Physiol Biochem 2015; 37:1178-86. [DOI: 10.1159/000430241] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2015] [Indexed: 11/19/2022] Open
Abstract
Background/Aims: The cyclin-dependent kinase 4 (CDK4) participates in the regulation of apoptosis of nucleated cells by altering transcriptional regulation of genes governing cell proliferation and cell death. Similar to apoptosis of nucleated cells, erythrocytes may enter eryptosis, which is characterized by cell shrinkage and cell membrane scrambling with phosphatidylserine (PS) exposure at the cell surface. As mature erythrocytes lack nuclei, acute stimulation of eryptosis cannot result from altered gene expression. Eryptosis is triggered by isotonic cell shrinkage following Cl- removal (replacement with the impermeant organic anion gluconate) or by oxidative stress (exposure to 0.3 mM tertbutyl-hydroperoxide [tBOOH]). The present study explored whether CDK4 is expressed in erythrocytes and whether the CDK4 inhibitors II (NSC625987) and III (ryuvidine) influence eryptosis. Methods: Western blotting was utilized for determination of the presence of CDK4 protein in human erythrocytes, and FACS analysis to determine Fluo3 fluorescence (reflecting cytosolic Ca2+), annexin-V-binding (reflecting PS-exposure) and forward scatter (reflecting cell volume). Results: CDK4 protein was present in human erythrocytes. Cl- removal was followed by decrease of forward scatter and increase of both annexin-V-binding and Fluo3 fluorescence, an effect significantly curtailed by CDK4 inhibitors II and III. Furthermore, CDK4 inhibition blunted enhanced PS-exposure elicited by tBOOH treatment. Conclusions: The present observations disclose the presence of CDK4 protein in human erythrocytes and the suppression of suicidal erythrocyte death by pharmacological inhibition of CDK4.
Collapse
|
11
|
Lang E, Jilani K, Bissinger R, Rexhepaj R, Zelenak C, Lupescu A, Lang F, Qadri SM. Vitamin D-Rich Diet in Mice Modulates Erythrocyte Survival. Kidney Blood Press Res 2015; 40:403-12. [PMID: 26227001 DOI: 10.1159/000368517] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Epidemiological evidence suggests that vitamin D deficiency is associated with anemia. The potent metabolite 1,25(OH)2 vitamin D3 [1,25(OH)2D3] activates various signaling cascades regulating a myriad of cellular functions including suicidal cell death or apoptosis. Suicidal death of erythrocytes or eryptosis is characterized by cell shrinkage and cell membrane scrambling leading to phosphatidylserine (PS) externalization. Stimulation of eryptosis may limit lifespan of circulating erythrocytes and thus cause anemia. In the present study, we explored the effect of a high vitamin D diet (10,000 I.U. vitamin D for 14 days) in mice on eryptosis. METHODS Plasma concentrations of erythropoietin were estimated using an immunoassay kit, blood count using an electronic hematology particle counter, relative reticulocyte numbers using Retic-COUNT® reagent, PS exposure at the cell surface from annexin V binding, cell volume from forward scatter, and cytosolic Ca(2+) ([Ca(2+)]i) from Fluo3-fluorescence in FACS analysis. RESULTS Vitamin D treatment decreased mean corpuscular volume, reticulocyte count, and plasma erythropoietin levels. Vitamin D treatment slightly but significantly decreased forward scatter but did not significantly modify spontaneous PS exposure and [Ca(2+)]i of freshly drawn erythrocytes. Vitamin D treatment augmented the stimulation of PS exposure and cell shrinkage following exposure to hyperosmotic shock (addition of 550 mM sucrose) or energy depletion (glucose removal) without significantly modifying [Ca(2+)]i. CONCLUSIONS The present observations point to a subtle effect of exogenous vitamin D supplementation on erythrocyte survival.
Collapse
Affiliation(s)
- Elisabeth Lang
- Department of Physiology, University of Tübingen, Germany
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Tahirović E, Lashki DJ, Trippel TD, Tscholl V, Fritschka M, Musial-Bright L, Busjahn A, Kolip P, Störk S, Rauchfuß M, Inkrot S, Lainscak M, Apostolović S, Vesković J, Lončar G, Doehner W, Zelenak C, Düngen HD. Validation of the FEW16 questionnaire for the assessment of physical well-being in patients with heart failure with reduced ejection fraction: results from the CIBIS-ELD study. ESC Heart Fail 2015; 2:194-203. [PMID: 27708856 PMCID: PMC5034814 DOI: 10.1002/ehf2.12045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 05/07/2015] [Accepted: 05/19/2015] [Indexed: 11/26/2022] Open
Abstract
Aims Patients with heart failure (HF) commonly suffer from severe impairment of quality of life (QoL). One main goal of HF treatment is improvement of QoL. Physical well‐being is an essential component of QoL. To enable assessment of physical well‐being in HF patients, we validated the FEW16 questionnaire in a prospective study with patients from the Cardiac Insufficiency Bisoprolol Study in ELDerly. Methods and results In 127 HF patients (age 73 ± 5.5 years, 72% male, 60% New York Heart Association class II, left ventricular ejection fraction 37 ± 8.5%), we measured physical well‐being (FEW16), QoL [36‐Item Short‐Form Health Survey (SF36)], and depressive symptoms [PRIME MD Patient Health Questionnaire German short version for depression (PHQ‐D)] at baseline and two follow‐up visits, and correlated FEW16 scores with QoL data and clinical parameters. FEW16 mean scores are 3.04 ± 1.04 at baseline, 3.19 ± 0.94 after 3 months, and 2.77 ± 0.94 after 2–4 years. We assessed data quality, scale assumptions, and construct validity and reliability. Cronbach's alpha for subscales resilience: 0.84; ability to enjoy: 0.80; vitality: 0.88; inner peace: 0.87; total score: 0.95. Intraclass correlation coefficient (ICC) is 0.87 (95% CI 0.84–0.89, ICC (1.4). Pearson's correlations of FEW16 with SF36 and PHQ‐D were significant. Six minutes walking distance and heart rate correlated significantly with the FEW16 total score. Conclusions The FEW16 showed good reliability, internal consistency, and intraclass correlation. FEW16 scores correlated well with psychological and physical well‐being (SF36) and clinical markers of exercise tolerance (6 min walk test and heart rate). Our results indicate a strong correlation of self‐reported physical well‐being with psychological factors. FEW16 values at baseline predicted the development of several aspects of QoL during beta‐blocker up‐titration.
Collapse
Affiliation(s)
- E Tahirović
- Department of Internal Medicine - Cardiology Charité University Medicine Berlin Germany
| | - D J Lashki
- Department of Internal Medicine - Cardiology Charité University Medicine Berlin Germany
| | - T D Trippel
- Department of Internal Medicine - CardiologyCharité University Medicine BerlinGermany; German Center for Cardiovascular Research (DZHK)Site BerlinGermany
| | - V Tscholl
- Medical Clinic for Cardiology and Pulmonology, Campus Benjamin Franklin Charité University Medicine Berlin Germany
| | - M Fritschka
- Department of Internal Medicine - Cardiology Charité University Medicine Berlin Germany
| | - L Musial-Bright
- Department of Internal Medicine - Cardiology Charité University Medicine Berlin Germany
| | | | - P Kolip
- Department of Prevention and Health Promotion, School of Public Health Bielefeld University Bielefeld Germany
| | - S Störk
- Comprehensive Heart Failure Center University of Würzburg Germany
| | - M Rauchfuß
- Centre of Internal Medicine and Dermatology, Clinic for Internal Medicine and Psychosomatics Charité University Medicine Berlin Germany
| | - S Inkrot
- Department of Internal Medicine - Cardiology Charité University Medicine Berlin Germany
| | - M Lainscak
- Department of Cardiology and Department of Research and EducationGeneral Hospital Celje, Slovenia and Faculty of Medicine, University of LjubljanaCeljeSlovenia; Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | - S Apostolović
- Clinical Center Niš, Department of Internal Medicine University of Niš Serbia
| | - J Vesković
- Department of Internal Medicine - Cardiology Charité University Medicine Berlin Germany
| | - G Lončar
- Cardiology Department Zvezdara University Medical Center Belgrade Serbia
| | - W Doehner
- Center for Stroke Research Charité University Medicine Berlin Germany
| | - C Zelenak
- Department of Internal Medicine - Cardiology Charité University Medicine Berlin Germany
| | - H D Düngen
- Department of Internal Medicine - Cardiology Charité University Medicine Berlin Germany
| |
Collapse
|
13
|
Bissinger R, Lupescu A, Zelenak C, Jilani K, Lang F. Stimulation of eryptosis by cryptotanshinone. Cell Physiol Biochem 2014; 34:432-42. [PMID: 25095724 DOI: 10.1159/000363012] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Cryptotanshinone, a component of Salvia miltiorrhiza Bunge roots, may trigger suicidal death or apoptosis of tumor cells and has thus been recommended for the prevention and treatment of malignancy. On the other hand, Cryptotanshinone has been shown to counteract apoptosis of neurons and hepatocytes. Similar to apoptosis of nucleated cells, erythrocytes may enter eryptosis, a suicidal death characterized by cell shrinkage and phosphatidylserine translocation to the erythrocyte surface. Eryptosis may be triggered by increase of cytosolic Ca(2+)-activity ([Ca(2+)]i). The present study explored whether Cryptotanshinone stimulates eryptosis. METHODS Forward scatter was taken as measure of cell volume, annexin V binding for identification of phosphatidylserine-exposing erythrocytes and Fluo3-fluorescence for determination of [Ca(2+)]i. RESULTS A 48 h exposure of human erythrocytes to Cryptotanshinone (10 µM) was followed by significant decrease of forward scatter, significant increase of the percentage annexin-V-binding cells and significant increase of [Ca(2+)]i. The effect of Cryptotanshinone (1 µM) on annexin-V-binding was virtually abrogated by removal of extracellular Ca(2+). CONCLUSION Cryptotanshinone is a powerful stimulator of suicidal erythrocyte death or eryptosis, which is effective mainly, if not exclusively, by stimulation of Ca(2+) entry.
Collapse
Affiliation(s)
- Rosi Bissinger
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | | | | | | | | |
Collapse
|
14
|
Buga AM, Margaritescu C, Scholz CJ, Radu E, Zelenak C, Popa-Wagner A. Transcriptomics of post-stroke angiogenesis in the aged brain. Front Aging Neurosci 2014; 6:44. [PMID: 24672479 PMCID: PMC3957426 DOI: 10.3389/fnagi.2014.00044] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [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: 12/30/2013] [Accepted: 02/27/2014] [Indexed: 12/27/2022] Open
Abstract
Despite the obvious clinical significance of post-stroke angiogenesis in aged subjects, a detailed transcriptomic analysis of post-stroke angiogenesis has not yet been undertaken in an aged experimental model. In this study, by combining stroke transcriptomics with immunohistochemistry in aged rats and post-stroke patients, we sought to identify an age-specific gene expression pattern that may characterize the angiogenic process after stroke. We found that both young and old infarcted rats initiated vigorous angiogenesis. However, the young rats had a higher vascular density by day 14 post-stroke. “New-for-stroke” genes that were linked to the increased vasculature density in young animals included Angpt2, Angptl2, Angptl4, Cib1, Ccr2, Col4a2, Cxcl1, Lef1, Hhex, Lamc1, Nid2, Pcam1, Plod2, Runx3, Scpep1, S100a4, Tgfbi, and Wnt4, which are required for sprouting angiogenesis, reconstruction of the basal lamina (BL), and the resolution phase. The vast majority of genes involved in sprouting angiogenesis (Angpt2, Angptl4, Cib1, Col8a1, Nrp1, Pcam1, Pttg1ip, Rac2, Runx1, Tnp4, Wnt4); reconstruction of a new BL (Col4a2, Lamc1, Plod2); or tube formation and maturation (Angpt1, Gpc3, Igfbp7, Sparc, Tie2, Tnfsf10), had however, a delayed upregulation in the aged rats. The angiogenic response in aged rats was further diminished by the persistent upregulation of “inflammatory” genes (Cxcl12, Mmp8, Mmp12, Mmp14, Mpeg1, Tnfrsf1a, Tnfrsf1b) and vigorous expression of genes required for the buildup of the fibrotic scar (Cthrc1, Il6ra, Il13ar1, Il18, Mmp2, Rassf4, Tgfb1, Tgfbr2, Timp1). Beyond this barrier, angiogenesis in the aged brains was similar to that in young brains. We also found that the aged human brain is capable of mounting a vigorous angiogenic response after stroke, which most likely reflects the remaining brain plasticity of the aged brain.
Collapse
Affiliation(s)
- Ana Maria Buga
- Department of Psychiatry, University of Medicine Rostock , Rostock , Germany ; Center of Clinical and Experimental Medicine, University of Medicine Craiova , Craiova , Romania
| | - Claudiu Margaritescu
- Center of Clinical and Experimental Medicine, University of Medicine Craiova , Craiova , Romania
| | - Claus Juergen Scholz
- IZKF Lab for Microarray Applications, University of Würzburg , Würzburg , Germany
| | - Eugen Radu
- University of Medicine and Pharmacy Carol Davila , Bucharest , Romania
| | - Christine Zelenak
- Molecular Oncology, Department of Medicine, Lady Davis Institute for Medical Research, McGill University , Montreal, QC , Canada
| | - Aurel Popa-Wagner
- Department of Psychiatry, University of Medicine Rostock , Rostock , Germany
| |
Collapse
|
15
|
Qadri SM, Mahmud H, Lang E, Gu S, Bobbala D, Zelenak C, Jilani K, Siegfried A, Föller M, Lang F. Enhanced suicidal erythrocyte death in mice carrying a loss-of-function mutation of the adenomatous polyposis coli gene. J Cell Mol Med 2012; 16:1085-93. [PMID: 21781276 PMCID: PMC4365887 DOI: 10.1111/j.1582-4934.2011.01387.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [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] [Indexed: 01/20/2023] Open
Abstract
Loss-of-function mutations in human adenomatous polyposis coli (APC) lead to multiple colonic adenomatous polyps eventually resulting in colonic carcinoma. Similarly, heterozygous mice carrying defective APC (apcMin/+) suffer from intestinal tumours. The animals further suffer from anaemia, which in theory could result from accelerated eryptosis, a suicidal erythrocyte death triggered by enhanced cytosolic Ca2+ activity and characterized by cell membrane scrambling and cell shrinkage. To explore, whether APC-deficiency enhances eryptosis, we estimated cell membrane scrambling from annexin V binding, cell size from forward scatter and cytosolic ATP utilizing luciferin–luciferase in isolated erythrocytes from apcMin/+ mice and wild-type mice (apc+/+). Clearance of circulating erythrocytes was estimated by carboxyfluorescein-diacetate-succinimidyl-ester labelling. As a result, apcMin/+ mice were anaemic despite reticulocytosis. Cytosolic ATP was significantly lower and annexin V binding significantly higher in apcMin/+ erythrocytes than in apc+/+ erythrocytes. Glucose depletion enhanced annexin V binding, an effect significantly more pronounced in apcMin/+ erythrocytes than in apc+/+ erythrocytes. Extracellular Ca2+ removal or inhibition of Ca2+ entry with amiloride (1 mM) blunted the increase but did not abrogate the genotype differences of annexin V binding following glucose depletion. Stimulation of Ca2+-entry by treatment with Ca2+-ionophore ionomycin (10 μM) increased annexin V binding, an effect again significantly more pronounced in apcMin/+ erythrocytes than in apc+/+ erythrocytes. Following retrieval and injection into the circulation of the same mice, apcMin/+ erythrocytes were more rapidly cleared from circulating blood than apc+/+ erythrocytes. Most labelled erythrocytes were trapped in the spleen, which was significantly enlarged in apcMin/+ mice. The observations point to accelerated eryptosis and subsequent clearance of apcMin/+ erythrocytes, which contributes to or even accounts for the enhanced erythrocyte turnover, anaemia and splenomegaly in those mice.
Collapse
Affiliation(s)
- Syed M Qadri
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Lupescu A, Shaik N, Jilani K, Zelenak C, Lang E, Pasham V, Zbidah M, Plate A, Bitzer M, Föller M, Qadri SM, Lang F. Enhanced erythrocyte membrane exposure of phosphatidylserine following sorafenib treatment: an in vivo and in vitro study. Cell Physiol Biochem 2012; 30:876-88. [PMID: 22907570 DOI: 10.1159/000341465] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2012] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Sorafenib (Nexavar(®)), a polytyrosine kinase inhibitor, stimulates apoptosis and is thus widely used for chemotherapy in hepatocellular carcinoma (HCC). Hematological side effects of Nexavar(®) chemotherapy include anemia. Erythrocytes may undergo apoptosis-like suicidal death or eryptosis, which is characterized by cell shrinkage and phosphatidylserine-exposure at the cell surface. Signaling leading to eryptosis include increase in cytosolic Ca(2+)activity ([Ca(2+)](i)), formation of ceramide, ATP-depletion and oxidative stress. The present study explored, whether sorafenib triggers eryptosis in vitro and in vivo. METHODS [Ca(2+)](i )was estimated from Fluo3-fluorescence, cell volume from forward scatter, phosphatidylserine-exposure from annexin-V-binding, hemolysis from hemoglobin release, ceramide with antibody binding-dependent fluorescence, cytosolic ATP with a luciferin-luciferase-based assay, and oxidative stress from 2',7' dichlorodihydrofluorescein diacetate (DCFDA) fluorescence. RESULTS A 48 h exposure of erythrocytes to sorafenib (≥0.5 µM) significantly increased Fluo 3 fluorescence, decreased forward scatter, increased annexin-V-binding and triggered slight hemolysis (≥5 µM), but did not significantly modify ceramide abundance and cytosolic ATP. Sorafenib treatment significantly enhanced DCFDA-fluorescence and the reducing agents N-acetyl-L-cysteine and tiron significantly blunted sorafenib-induced phosphatidylserine exposure. Nexavar(®) chemotherapy in HCC patients significantly enhanced the number of phosphatidylserine-exposing erythrocytes. CONCLUSIONS The present observations disclose novel effects of sorafenib, i.e. stimulation of suicidal erythrocyte death or eryptosis, which may contribute to the pathogenesis of anemia in Nexavar(®)-based chemotherapy.
Collapse
|
17
|
Lang E, Qadri SM, Jilani K, Zelenak C, Lupescu A, Schleicher E, Lang F. Carbon monoxide-sensitive apoptotic death of erythrocytes. Basic Clin Pharmacol Toxicol 2012; 111:348-55. [PMID: 22726235 DOI: 10.1111/j.1742-7843.2012.00915.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 06/19/2012] [Indexed: 11/29/2022]
Abstract
Carbon monoxide (CO) intoxication severely interferes with the oxygen-transporting function of haemoglobin. Beyond that, CO participates in the regulation of apoptosis. CO could be generated from CO-releasing molecules (CORM), such as the tricarbonyl-dichlororuthenium (II) dimer (CORM-2), which is presently considered for the treatment of vascular dysfunction, inflammation, tissue ischaemia and organ rejection. CORM-2 is at least partially effective by modifying gene expression and mitochondrial potential. Erythrocytes lack nuclei and mitochondria but may undergo suicidal cell death or eryptosis, characterized by cell shrinkage and phospholipid scrambling of the cell membrane. Eryptosis is triggered by the increase in cytosolic Ca²⁺ activity ([Ca²⁺](i)). The present study explored whether CORM-2 influences eryptosis. To this end, [Ca²⁺](i) was estimated from Fluo-3-fluorescence, cell volume from forward scatter, phospholipid scrambling from annexin-V-binding and haemolysis from haemoglobin release. CO-binding haemoglobin (COHb) was estimated utilizing a blood gas analyser. As a result, exposure of erythrocytes for 24 hr to CORM-2 (≥5 μM) significantly increased COHb, [Ca²⁺](i) , forward scatter, annexin-V-binding and haemolysis. Annexin-V-binding was significantly blunted by 100% oxygen and was virtually abolished in the nominal absence of Ca²⁺. In conclusion, CORM-2 stimulates cell membrane scrambling of erythrocytes, an effect largely due to Ca²⁺ entry and partially reversed by O₂.
Collapse
Affiliation(s)
- Elisabeth Lang
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | | | | | | | | | | | | |
Collapse
|
18
|
Lupescu A, Jilani K, Zelenak C, Zbidah M, Shaik N, Lang F. Induction of programmed erythrocyte death by gambogic acid. Cell Physiol Biochem 2012; 30:428-38. [PMID: 22814240 DOI: 10.1159/000339036] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2012] [Indexed: 11/19/2022] Open
Abstract
Gambogic acid, a xanthone from Garcinia hanburyi, stimulates apoptosis and has thus anticancer potency. Similar to apoptosis of nucleated cells, erythrocytes may undergo apoptosis-like suicidal death or eryptosis, which is characterized by cell shrinkage and cell membrane scrambling leading to phosphatidylserine-exposure at the cell surface. Eryptosis could be triggered by increase of cytosolic Ca(2+)-activity ([Ca(2+)](i)), ceramide formation, ATP-depletion and caspase activation. The present study explored, whether gambogic acid triggers eryptosis of human erythrocytes. [Ca(2+)](i )was estimated utilizing Fluo-3 fluorescence, cell volume from forward scatter, phosphatidylserine-exposure from annexin-V-binding, hemolysis from hemoglobin release, ceramide abundance utilizing antibodies, and cytosolic ATP with luciferin- luciferase. A 48 h exposure to gambogic acid (500 nM) significantly increased [Ca(2+)](i), stimulated ceramide formation, decreased forward scatter and increased annexin-V-binding. Gambogic acid exposure was followed by a slight but significant increase of hemolysis. Gambogic acid did not significantly modify cytosolic ATP-concentration. Removal of extracellular Ca(2+) slightly, but significantly blunted the effect of gambogic acid (500 nM) on annexin-V-binding. The present observations disclose a novel effect of gambogic acid, i.e. stimulation of suicidal death of human erythrocytes or eryptosis, paralleled by Ca(2+)-entry, ceramide formation, cell shrinkage and phosphatidylserine-exposure.
Collapse
Affiliation(s)
- Adrian Lupescu
- Department of Physiology, University of Tübingen, Gmelinstrasse 5, Tübingen, Germany
| | | | | | | | | | | |
Collapse
|
19
|
Kucherenko Y, Zelenak C, Eberhard M, Qadri SM, Lang F. Effect of casein kinase 1α activator pyrvinium pamoate on erythrocyte ion channels. Cell Physiol Biochem 2012; 30:407-17. [PMID: 22814238 DOI: 10.1159/000339034] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2012] [Indexed: 11/19/2022] Open
Abstract
Pharmacological modification of protein kinase CK1 (casein kinase 1) has previously been shown to influence suicidal erythrocyte death or eryptosis, which is triggered by activation of Cl(-)-sensitive Ca(2+)-permeable cation channels. Ca(2+) entering through those channels stimulates cell membrane scrambling and opens Ca(2+)-activated K(+)-channels resulting in KCl exit and thus cell shrinkage. The specific CK1-inhibitor D4476 (1 µM) blunted, whereas the specific CK1 αactivator pyrvinium pamoate (10 µM) enhanced cell membrane scrambling. The substances were at least partially effective through modification of cytosolic Ca(2+)-activity. The present study explored, whether pyrvinium pamoate indeed influences Cl(-)-sensitive cation-channels in erythrocytes. As a result, removal of Cl(-)increased Fluo3-fluorescence (reflecting cytosolic Ca(2+)-activity), triggered cell membrane scrambling (apparent from annexin-V-binding), and decreased forward scatter (pointing to cell shrinkage). Pyrvinium pamoate significantly augmented the effect of Cl(-)-removal on Fluo3 fluorescence and annexin-V-binding, but blunted the effect on forward scatter. According to whole cell patch clamp recording, Cl(-)removal activated a cation current, which was significantly enhanced by pyrvinium pamoate. Pyrvinium pamoate inhibited Ca(2+)-activated K(+)-channels. Ca(2+)-ionophore ionomycin (1 µM) decreased forward scatter, an effect significantly blunted by pyrvinium pamoate. In conclusion, pyrvinium pamoate activates Cl(-)-sensitive Ca(2+)-permeable cation channels with subsequent Ca(2+)-entry and inhibits Ca(2+)-activated K(+)-channels thus blunting the stimulating effect of Ca(2+) on those channels, K(+)-exit and thus cell shrinkage.
Collapse
Affiliation(s)
- Yuliya Kucherenko
- Department of Physiology, University of Tübingen, Gmelinstrasse 5, Tübingen, Germany
| | | | | | | | | |
Collapse
|
20
|
Zelenak C, Pasham V, Jilani K, Tripodi PM, Rosaclerio L, Pathare G, Lupescu A, Faggio C, Qadri SM, Lang F. Tanshinone IIA stimulates erythrocyte phosphatidylserine exposure. Cell Physiol Biochem 2012; 30:282-94. [PMID: 22759974 DOI: 10.1159/000339064] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2012] [Indexed: 11/19/2022] Open
Abstract
Tanshinone IIA, an antimicrobial, antioxidant, antianaphylactic, antifibrotic, vasodilating, antiatherosclerotic, organo-protective and antineoplastic component from the rhizome of Salvia miltiorrhiza, is known to trigger apoptosis of tumor cells. Tanshinone IIA is effective in part through mitochondrial depolarization and altered gene expression. Erythrocytes lack mitochondria and nuclei but may undergo eryptosis, an apoptosis-like suicidal cell death characterized by cell shrinkage and cell membrane scrambling with phosphatidylserine exposure at the cell surface. Eryptosis is triggered by increase of cytosolic Ca(2+) activity, ATP depletion and ceramide formation. The present study explored, whether tanshinone IIA elicits eryptosis. Cytosolic Ca(2+)-concentration was determined from Fluo3-fluorescence, cell volume from forward scatter, phosphatidylserine exposure from binding of fluorescent annexin V, hemolysis from hemoglobin concentration in the supernatant, ATP concentration utilizing luciferin-luciferase and ceramide formation utilizing fluorescent anticeramide antibodies. Clearance of circulating erythrocytes was estimated by CFSE-labeling. A 48 h exposure to tanshinone IIA (≥10 µM) significantly increased cytosolic Ca(2+)-concentration, decreased ATP concentration (25 µM), increased lactate concentration (25 µM), increased ceramide formation (25 µM), decreased forward scatter, increased annexin-V-binding and increased (albeit to a much smaller extent) hemolysis. The effect of 25 µM tanshinone IIA on annexin-V binding was partially reversed in the nominal absence of Ca(2+). Labelled tanshinone IIA-treated erythrocytes were more rapidly cleared from the circulating blood in comparison to untreated erythrocytes. The present observations reveal a completely novel effect of tanshinone IIA, i.e. triggering of Ca(2+) entry, ATP depletion and ceramide formation in erythrocytes, events eventually leading to eryptosis with cell shrinkage and cell membrane scrambling.
Collapse
Affiliation(s)
- Christine Zelenak
- Department of Physiology, University of Tuebingen, Tuebingen, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Pasham V, Rotte A, Yang W, Zelenak C, Bhandaru M, Föller M, Lang F. OSR1-sensitive regulation of Na+/H+ exchanger activity in dendritic cells. Am J Physiol Cell Physiol 2012; 303:C416-26. [PMID: 22648948 DOI: 10.1152/ajpcell.00420.2011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The oxidative stress-responsive kinase 1 (OSR1) is activated by WNK (with no K kinases) and in turn stimulates the thiazide-sensitive Na-Cl cotransporter (NCC) and the furosemide-sensitive Na-K-2Cl cotransporter (NKCC), thus contributing to transport and cell volume regulation. Little is known about extrarenal functions of OSR1. The present study analyzed the impact of decreased OSR1 activity on the function of dendritic cells (DCs), antigen-presenting cells linking innate and adaptive immunity. DCs were cultured from bone marrow of heterozygous WNK-resistant OSR1 knockin mice (osr(KI)) and wild-type mice (osr(WT)). Cell volume was estimated from forward scatter in FACS analysis, ROS production from 2',7'-dichlorodihydrofluorescein-diacetate fluorescence, cytosolic pH (pH(i)) from 2',7'-bis-(2-carboxyethyl)-5-(and-6)-carboxyfluorescein fluorescence, and Na(+)/H(+) exchanger activity from Na(+)-dependent realkalinization following ammonium pulse and migration utilizing transwell chambers. DCs expressed WNK1, WNK3, NCC, NKCC1, and OSR1. Phosphorylated NKCC1 was reduced in osr(KI) DCs. Cell volume and pH(i) were similar in osr(KI) and osr(WT) DCs, but Na(+)/H(+) exchanger activity and ROS production were higher in osr(KI) than in osr(WT) DCs. Before LPS treatment, migration was similar in osr(KI) and osr(WT) DCs. LPS (1 μg/ml), however, increased migration of osr(WT) DCs but not of osr(KI) DCs. Na(+)/H(+) exchanger 1 inhibitor cariporide (10 μM) decreased cell volume, intracellular reactive oxygen species (ROS) formation, Na(+)/H(+) exchanger activity, and pH(i) to a greater extent in osr(KI) than in osr(WT) DCs. LPS increased cell volume, Na(+)/H(+) exchanger activity, and ROS formation in osr(WT) DCs but not in osr(KI) DCs and blunted the difference between osr(KI) and osr(WT) DCs. Na(+)/H(+) exchanger activity in osr(WT) DCs was increased by the NKCC1 inhibitor furosemide (100 nM) to values similar to those in osr(KI) DCs. Oxidative stress (10 μM tert-butyl-hydroperoxide) increased Na(+)/H(+) exchanger activity in osr(WT) DCs but not in osr(KI) DCs and reversed the difference between genotypes. Cariporide virtually abrogated Na(+)/H(+) exchanger activity in both genotypes and blunted LPS-induced cell swelling and ROS formation in osr(WT) mice. In conclusion, partial OSR1 deficiency influences Na(+)/H(+) exchanger activity, ROS formation, and migration of dendritic cells.
Collapse
|
22
|
Zelenak C, Eberhard M, Jilani K, Qadri SM, Macek B, Lang F. Protein kinase CK1α regulates erythrocyte survival. Cell Physiol Biochem 2012; 29:171-80. [PMID: 22415086 DOI: 10.1159/000337598] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2012] [Indexed: 01/14/2023] Open
Abstract
Protein kinase CK1 (casein kinase 1) isoforms are involved in the regulation of various physiological functions including apoptosis. The specific CK1 inhibitor D4476 may either inhibit or foster apoptosis. Similar to apoptosis of nucleated cells, eryptosis, the suicidal death of erythrocytes, is paralleled by cell shrinkage and cell membrane scrambling with phosphatidylserine exposure at the cell surface. Triggers of eryptosis include increase of cytosolic Ca(2+) activity following energy depletion (removal of glucose) or oxidative stress (exposure to the oxidant tert-butyl hydroperoxide [TBOOH]). Western blotting was utilized to verify that erythrocytes express the protein kinase CK1α, and FACS analysis to determine whether the CK1 inhibitor D4476 and CK1α activator pyrvinium pamoate modify forward scatter (reflecting cell volume), annexin V binding (reflecting phosphatidylserine exposure), and Fluo3 fluorescence (reflecting cytosolic Ca(2+) activity). As a result, both, human and murine erythrocytes express CK1 isoform α. Glucose depletion (48 hours) and exposure to 0.3 mM TBOOH (30 minutes) both decreased forward scatter, increased annexin V binding and increased Fluo3 fluorescence. CK1 inhibitor D4476 (10 μM) significantly blunted the decrease in forward scatter, the increase in annexin V binding and the increase in Fluo 3 fluorescence. (R)-DRF053, another CK1 inhibitor, similarly blunted the increase in annexin V binding upon glucose depletion. The CK1α specific activator pyrvinium pamoate (10 μM) significantly enhanced the increase in annexin V binding and Fluo3 fluorescence upon glucose depletion and TBOOH exposure. In the presence of glucose, pyrvinium pamoate slightly but significantly increased Fluo3 fluorescence. In conclusion, CK1 isoform α participates in the regulation of erythrocyte programmed cell death by modulating cytosolic Ca(2+) activity.
Collapse
|
23
|
Yang W, Bhandaru M, Pasham V, Bobbala D, Zelenak C, Jilani K, Rotte A, Lang F. Effect of Thymoquinone on Cytosolic pH and Na +/H + Exchanger Activity in Mouse Dendritic Cells. Cell Physiol Biochem 2012; 29:21-30. [DOI: 10.1159/000337583] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2012] [Indexed: 01/13/2023] Open
|
24
|
Rotte A, Pasham V, Bhandaru M, Bobbala D, Zelenak C, Lang F. Rapamycin Sensitive ROS Formation and Na+/H+Exchanger Activity in Dendritic Cells. Cell Physiol Biochem 2012; 29:543-50. [DOI: 10.1159/000338508] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2012] [Indexed: 11/19/2022] Open
|
25
|
Gatidis S, Zelenak C, Fajol A, Lang E, Jilani K, Michael D, Qadri SM, Lang F. p38 MAPK activation and function following osmotic shock of erythrocytes. Cell Physiol Biochem 2011; 28:1279-86. [PMID: 22179015 DOI: 10.1159/000335859] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2011] [Indexed: 01/17/2023] Open
Abstract
p38 protein kinase is activated by hyperosmotic shock, participates in the regulation of cell volume sensitive transport and metabolism and is involved in the regulation of various physiological functions including cell proliferation and apoptosis. Similar to apoptosis of nucleated cells, erythrocytes may undergo suicidal death or eryptosis, which is paralleled by cell shrinkage and cell membrane scrambling with phosphatidylserine exposure at the cell surface. Triggers of eryptosis include hyperosmotic shock, which increases cytosolic Ca(2+) activity and ceramide formation. The present study explored whether p38 kinase is expressed in human erythrocytes, is activated by hyperosmotic shock and participates in the regulation of eryptosis. Western blotting was utilized to determine phosphorylation of p38 kinase, forward scatter to estimate cell volume, annexin V binding to depict phosphatidylserine exposure and Fluo3 fluorescence to estimate cytosolic Ca(2+) activity. As a result, erythrocytes express p38 kinase, which is phosphorylated upon osmotic shock (+550 mM sucrose). Osmotic shock decreased forward scatter, increased annexin V binding and increased Fluo3 fluorescence, all effects significantly blunted by the p38 kinase inhibitors SB203580 (2 μM) and p38 Inh III (1 μM). In conclusion, p38 kinase is expressed in erythrocytes and participates in the machinery triggering eryptosis following hyperosmotic shock.
Collapse
Affiliation(s)
- Sergios Gatidis
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Qadri SM, Kucherenko Y, Zelenak C, Jilani K, Lang E, Lang F. Dicoumarol activates Ca2+-permeable cation channels triggering erythrocyte cell membrane scrambling. Cell Physiol Biochem 2011; 28:857-64. [PMID: 22178938 DOI: 10.1159/000335800] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2011] [Indexed: 01/17/2023] Open
Abstract
Dicoumarol, a widely used anticoagulant, may cause anemia, which may result from enhanced erythrocyte loss due to bleeding or due to accelerated erythrocyte death. Erythrocytes may undergo suicidal death or eryptosis, characterized by cell shrinkage and phospholipid scrambling of the cell membrane. Eryptosis may be triggered by increase of cytosolic Ca(2+)-activity ([Ca(2+)](i)). The present study explored, whether dicoumarol induces eryptosis. [Ca(2+)](i) was estimated from Fluo3-fluorescence, cation channel activity utilizing whole cell patch clamp, cell volume from forward scatter, phospholipid scrambling from annexin-V-binding, and hemolysis from haemoglobin release. Exposure of erythrocytes for 48 hours to dicoumarol (=10 μM) significantly increased [Ca(2+)](i), enhanced cation channel activity, decreased forward scatter, triggered annexin-V-binding and elicited hemolysis. Following exposure to 30 μM dicoumarol, annexin-V-binding affected approximately 15%, and hemolysis 2% of treated erythrocytes. The stimulation of annexin-V-binding by dicoumarol was abrogated in the nominal absence of Ca(2+). In conclusion, dicoumarol stimulates suicidal death of erythrocytes by stimulating Ca(2+) entry and subsequent triggering of Ca(2+) dependent cell membrane scrambling.
Collapse
Affiliation(s)
- Syed M Qadri
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | | | | | | | | | | |
Collapse
|
27
|
Lupescu A, Jilani K, Zelenak C, Zbidah M, Qadri SM, Lang F. Hexavalent chromium-induced erythrocyte membrane phospholipid asymmetry. Biometals 2011; 25:309-18. [PMID: 22080200 DOI: 10.1007/s10534-011-9507-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Accepted: 10/18/2011] [Indexed: 12/27/2022]
Abstract
Hexavalent (VI) chromium is a global contaminant with cytotoxic activity. Chromium (VI) induces oxidative stress, inflammation, cell proliferation, malignant transformation and may trigger carcinogenesis and at the same time apoptosis. The toxic effects of chromium (VI) at least partially result from mitochondrial injury and DNA damage. Erythrocytes lack mitochondria and nuclei but may experience an apoptosis-like suicidal cell death, i.e. eryptosis, which is characterized by cell shrinkage and cell membrane scrambling with phosphatidylserine exposure at the cell surface. Eryptosis may result from increase of cytosolic Ca(2+) activity, ATP depletion and/or ceramide formation. The present study explored, whether chromium (VI) triggers eryptosis. Fluo-3-fluorescence was employed to determine cytosolic Ca(2+)-concentration, forward scatter to estimate cell volume, binding of fluorescent annexin V to detect phosphatidylserine exposure, hemoglobin concentration in the supernatant to quantify hemolysis, luciferin-luciferase to determine cytosolic ATP concentration and fluorescent anti-ceramide antibodies to uncover ceramide formation. A 48 h exposure to chromium (VI) (≥10 μM) significantly increased cytosolic Ca(2+)-concentration, decreased ATP concentration (20 μM), decreased forward scatter, increased annexin V-binding and increased (albeit to a much smaller extent) hemolysis. Chromium (VI) did not significantly modify ceramide formation. The effect of 20 μM chromium (VI) on annexin V binding was partially reversed in the nominal absence of Ca(2+). The present observations disclose a novel effect of chromium (VI), i.e. Ca(2+) entry and cytosolic ATP depletion in erythrocytes, effects resulting in eryptosis with cell shrinkage and cell membrane scrambling.
Collapse
Affiliation(s)
- Adrian Lupescu
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | | | | | | | | | | |
Collapse
|
28
|
Abstract
Ursolic acid (1), a triterpenoid with pleotropic effects including inhibition of tumor growth, is well known to trigger apoptosis of nucleated cells. The effect is at least partially due to altered gene expression and mitochondrial dysfunction. Erythrocytes lack nuclei and mitochondria but, similar to nucleated cells, may undergo suicidal cell death or eryptosis, which is characterized by cell shrinkage and phospholipid scrambling of the cell membrane. Triggers of eryptosis include increase of cytosolic Ca2+ activity ([Ca2+]i), ceramide formation and/or ATP depletion. The present study has investigated whether or not 1 induces eryptosis. [Ca2+]i was estimated from Fluo-3 fluorescence, cell volume from forward scatter, phospholipid scrambling from annexin V binding, hemolysis from hemoglobin release, and cytosolic ATP concentration ([ATP]i) utilizing a luciferase assay and ceramide-utilizing fluorescent antibodies in FACS analysis. As a result, exposure of erythrocytes for 48 h to 1 (≥5 μM) did not significantly modify [ATP]i, but significantly increased [Ca2+]i, stimulated ceramide formation, decreased forward scatter, triggered annexin V binding, and elicited hemolysis. At 5 μM, 1 stimulated phospholipid scrambling in 10% and hemolysis in 2% of treated erythrocytes. Annexin V binding was blunted in the nominal absence of Ca2+. In conclusion, the food component ursolic acid stimulates suicidal death of erythrocytes, i.e., cells devoid of nuclei and mitochondria.
Collapse
Affiliation(s)
- Kashif Jilani
- Department of Physiology, University of Tuebingen, Gmelinstraße 5, 72076 Tuebingen, Germany
| | | | | | | | | | | |
Collapse
|
29
|
Lang E, Jilani K, Zelenak C, Pasham V, Bobbala D, Qadri SM, Lang F. Stimulation of suicidal erythrocyte death by benzethonium. Cell Physiol Biochem 2011; 28:347-54. [PMID: 21865743 DOI: 10.1159/000331751] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2011] [Indexed: 01/03/2023] Open
Abstract
Benzethonium, an antimicrobial surfactant widely used as preservative of pharmaceuticals, topical wound care product and oral disinfectant, triggers apoptosis of several cell types. The apoptosis is preceded and possibly triggered by mitochondrial depolarization. Even though lacking mitochondria, erythrocytes may similarly undergo suicidal cell death or eryptosis. Hallmarks of eryptosis include cell shrinkage and cell membrane scrambling with phosphatidylserine exposure at the cell surface. Eryptosis may be triggered by energy depletion, which leads to increase of cytosolic Ca(2+)-activity with subsequent Ca(2+)-sensitive cell shrinkage and cell membrane scrambling. Ca(2+)-sensitivity is enhanced by ceramide. The present study explored the effect of benzethonium on eryptosis. Cell membrane scrambling was estimated from binding of fluorescent annexin V to phosphatidylserine, cell volume from forward scatter in FACS analysis, cytosolic Ca(2+)-concentration from Fluo3-fluorescence, hemolysis from hemoglobin release, lactate formation by colorimetry and ceramide utilizing fluorescent antibodies. A 48 hours exposure to benzethonium (=5μM) significantly increased cytosolic Ca(2+)-concentration, decreased forward scatter and triggered annexin V-binding affecting some 30% of the erythrocytes at 5 μM benzethonium. Only 5% of treated erythrocytes were hemolytic. The effects of benzethonium on annexin V binding were blunted in the nominal absence of Ca(2+) and in the presence of amiloride (1 mM) but not in the presence of the pancaspase inhibitor zVAD (10 μM). Benzethonium further significantly enhanced the effect of glucose depletion on cytosolic Ca(2+)-concentration and annexin V-binding, but significantly blunted the effect of glucose depletion on forward scatter. Benzethonium (5 μM) significantly enhanced lactic acid formation but not ceramide abundance. The present observations disclose a novel effect of benzethonium, i.e. triggering of suicidal death of erythrocytes.
Collapse
Affiliation(s)
- Elisabeth Lang
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | | | | | | | | | | | | |
Collapse
|
30
|
Qadri SM, Bauer J, Zelenak C, Mahmud H, Kucherenko Y, Lee SH, Ferlinz K, Lang F. Sphingosine but not sphingosine-1-phosphate stimulates suicidal erythrocyte death. Cell Physiol Biochem 2011; 28:339-46. [PMID: 21865742 DOI: 10.1159/000331750] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2011] [Indexed: 12/14/2022] Open
Abstract
Sphingosine kinase 1 phosphorylates sphingosine, which is converted to ceramide by ceramide synthetase. Ceramide triggers eryptosis, the suicidal erythrocyte death characterized by cell shrinkage and phosphatidylserine (PS) exposure at the erythrocyte surface. Erythrocytes lack sphingosine phosphate-degrading enzymes and thus store large quantities of sphingosine phosphate. The present study explored the influence of sphingosine and sphingosine phosphate on eryptosis. [Ca(2+)](i), was estimated from Fluo3 fluorescence, cell volume from forward scatter and PS exposure from annexin V-binding in FACS analysis. Sphingosine (0.1 - 10 μM) but not sphingosine-1- phosphate (0.1 - 10 μM) increased [Ca(2+)](i), decreased cell volume and increased PS-exposure. The observations disclose sphingosine, but not sphingosine-1-phosphate, as a strong inducer of eryptosis.
Collapse
Affiliation(s)
- Syed M Qadri
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Gatidis S, Meier A, Jilani K, Lang E, Zelenak C, Qadri SM, Lang F. Phlorhizin protects against erythrocyte cell membrane scrambling. J Agric Food Chem 2011; 59:8524-8530. [PMID: 21707031 DOI: 10.1021/jf201938d] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Phlorhizin interferes with glucose transport. Glucose depletion triggers suicidal erythrocyte death or eryptosis, characterized by cell shrinkage and cell membrane scrambling. Eryptosis is further triggered by oxidative stress. The present study explored whether phlorhizin influences eryptosis following glucose depletion or oxidative stress. Cell membrane scrambling was estimated from annexin binding, cell volume from forward scatter (FSC), and cytosolic Ca(2+) concentration from Fluo-3 fluorescence. Phlorhizin (10-100 μM) added alone did not modify scrambling, FSC, or Fluo-3 fluorescence. Glucose depletion (48 h) significantly increased Fluo-3 fluorescence, decreased FSC, and increased annexin binding, effects in part significantly blunted by phlorhizin (annexin binding ≥ 10 μM, FSC ≥ 50 μM). Oxidative stress (30 min 0.3 mM tert-butylhydroperoxide) again significantly increased Fluo-3 fluorescence and triggered annexin binding, effects again in part significantly blunted by phlorhizin (Fluo-3 fluorescence ≥ 50 μM, annexin-binding ≥ 10 μM). Phlorhizin did not blunt the cell shrinkage induced by oxidative stress. The present observations disclose a novel effect of phlorhizin, that is, an influence on suicidal erythrocyte death following energy depletion and oxidative stress.
Collapse
Affiliation(s)
- Sergios Gatidis
- Department of Physiology, University of Tübingen, Tuebingen, Germany
| | | | | | | | | | | | | |
Collapse
|
32
|
Jilani K, Qadri SM, Lang E, Zelenak C, Rotte A, Bobbala D, Lang F. Stimulation of erythrocyte phospholipid scrambling by enniatin A. Mol Nutr Food Res 2011; 55 Suppl 2:S294-302. [PMID: 21823219 DOI: 10.1002/mnfr.201100156] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Revised: 05/03/2011] [Accepted: 06/07/2011] [Indexed: 01/03/2023]
Abstract
SCOPE Enniatin A, a peptide antibiotic and common food contaminant, triggers mitochondrial dysfunction and apoptosis. Even though lacking mitochondria, erythrocytes may similarly undergo suicidal cell death or eryptosis. Eryptosis is characterized by cell shrinkage and cell membrane phospholipid scrambling. Triggers of phospholipid scrambling include energy depletion and increase in cytosolic Ca(2+) activity ([Ca(2+) ](i) ). The present study explored whether enniatin A triggers phospholipid scrambling. METHODS AND RESULTS Phospholipid scrambling was estimated from annexin-V-binding, cell volume from forward scatter (FSC), [Ca(2+) ](i) from Fluo3-fluorescence, cytosolic ATP-concentration ([ATP](i) ) using a luciferase assay and hemolysis from hemoglobin release. Exposure of erythrocytes for 48 h to enniatin A (≥ 2.5 μM) significantly increased [Ca(2+) ](i) , decreased [ATP](i) , decreased FSC, triggered annexin-V-binding and elicited hemolysis. Annexin-V-binding affected 25%, and hemolysis 2% of treated erythrocytes. Decreased [ATP](i) by glucose depletion for 48 h was similarly followed by increased [Ca(2+) ](i) , decreased FSC and annexin-V-binding. Enniatin A augmented the effect on [Ca(2+) ](i) and annexin-V-binding, but not on FSC. Annexin-V-binding was blunted by Ca(2+) removal, by the cation channel inhibitor amiloride (1 mM), by the protein kinase C inhibitor staurosporine (500 nM) but not by the pancaspase inhibitor zVAD (10 μM). CONCLUSION The food contaminant enniatin A triggers ATP depletion and increases cytosolic Ca(2+) activity, effects resulting in suicidal erythrocyte death.
Collapse
Affiliation(s)
- Kashif Jilani
- Department of Physiology, University of Tuebingen, Tuebingen, Germany
| | | | | | | | | | | | | |
Collapse
|
33
|
Tang C, Zelenak C, Völkl J, Eichenmüller M, Regel I, Fröhlich H, Kempe D, Jimenez L, Le Bellego L, Vergne S, Lang F. Hydration-sensitive gene expression in brain. Cell Physiol Biochem 2011; 27:757-68. [PMID: 21691093 DOI: 10.1159/000330084] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2011] [Indexed: 12/16/2022] Open
Abstract
Dehydration has a profound influence on neuroexcitability. The mechanisms remained, however, incompletely understood. The present study addressed the effect of water deprivation on gene expression in the brain. To this end, animals were exposed to a 24 hours deprivation of drinking water and neuronal gene expression was determined by microarray technology with subsequent confirmation by RT-PCR. As a result, water deprivation was followed by significant upregulation of clathrin (light polypeptide Lcb), serum/glucocorticoid-regulated kinase (SGK) 1, and protein kinase A (PRKA) anchor protein 8-like. Water deprivation led to downregulation of janus kinase and microtubule interacting protein 1, neuronal PAS domain protein 4, thrombomodulin, purinergic receptor P2Y - G-protein coupled 13 gene, gap junction protein beta 1, neurotrophin 3, hyaluronan and proteoglycan link protein 1, G protein-coupled receptor 19, CD93 antigen, forkhead box P1, suppressor of cytokine signaling 3, apelin, immunity-related GTPase family M, serine (or cysteine) peptidase inhibitor clade B member 1a, serine (or cysteine) peptidase inhibitor clade H member 1, glutathion peroxidase 8 (putative), discs large (Drosophila) homolog-associated protein 1, zinc finger and BTB domain containing 3, and H2A histone family member V. Western blotting revealed the downregulation of forkhead box P1, serine (or cysteine) peptidase inhibitor clade H member 1, and gap junction protein beta 1 protein abundance paralleling the respective alterations of transcript levels. In conclusion, water deprivation influences the transcription of a wide variety of genes in the brain, which may participate in the orchestration of brain responses to water deprivation.
Collapse
Affiliation(s)
- Cai Tang
- Department of Physiology, University of Tübingen, Gmelinstr. 5, D-72076 Tübingen
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Sopjani M, Alesutan I, Dërmaku-Sopjani M, Gu S, Zelenak C, Munoz C, Velic A, Föller M, Rosenblatt KP, Kuro-o M, Lang F. Regulation of the Na+
/K+
ATPase by Klotho. FEBS Lett 2011; 585:1759-64. [DOI: 10.1016/j.febslet.2011.05.021] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Revised: 05/03/2011] [Accepted: 05/04/2011] [Indexed: 11/29/2022]
|
35
|
Abstract
Blebbistatin, a myosin II inhibitor, interferes with myosin-actin interaction and microtubule assembly. By influencing cytoskeletal dynamics blebbistatin counteracts apoptosis of several types of nucleated cells. Even though lacking nuclei and mitochondria, erythrocytes may undergo suicidal cell death or eryptosis, which is characterized by cell shrinkage and cell membrane scrambling with phosphatidylserine exposure at the cell surface. Triggers of eryptosis include energy depletion and osmotic shock, which enhance cytosolic Ca(2+) activity with subsequent Ca(2+)-sensitive cell shrinkage and cell membrane scrambling. The present study explored the effect of blebbistatin on eryptosis. Cell membrane scrambling was estimated from binding of annexin V to phosphatidylserine at the erythrocyte surface, cell volume from forward scatter in fluorescence-activated cell sorting analysis and cytosolic Ca(2+) concentration from Fluo3 fluorescence. Exposure to blebbistatin on its own (1-50 μM) did not significantly modify cytosolic Ca(2+) concentration, forward scatter, or annexin V binding. Glucose depletion (48 h) was followed by a significant increase of Fluo3 fluorescence and annexin V binding, effects significantly blunted by blebbistatin (Fluo3 fluorescence ≥ 25 μM, annexin V binding ≥ 10 μM). Osmotic shock (addition of 550 mM sucrose) again significantly increased Fluo3 fluorescence and annexin binding, effects again significantly blunted by blebbistatin (Fluo3 fluorescence ≥ 25 μM, annexin V binding ≥ 25 μM). The present observations disclose a novel effect of blebbistatin, i.e., an influence on Ca(2+) entry and suicidal erythrocyte death following energy depletion and osmotic shock.
Collapse
Affiliation(s)
- Elisabeth Lang
- Department of Physiology, University of Tübingen, Germany
| | | | | | | | | | | | | |
Collapse
|
36
|
Jilani K, Qadri SM, Zelenak C, Lang F. Stimulation of suicidal erythrocyte death by oridonin. Arch Biochem Biophys 2011; 511:14-20. [PMID: 21575590 DOI: 10.1016/j.abb.2011.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Revised: 04/26/2011] [Accepted: 05/01/2011] [Indexed: 01/04/2023]
Abstract
Oridonin triggers apoptosis of cancer cells and was suggested as anticancer agent. Oridonin is partially effective through mitochondrial depolarization and partially by modifying gene expression. Erythrocytes lack mitochondria and nuclei but may undergo eryptosis, a suicidal cell death characterized by cell shrinkage and cell membrane scrambling with phosphatidylserine exposure at the cell surface. Triggers of eryptosis include increase of cytosolic Ca(2+)-activity, ATP depletion and ceramide formation. The present study explored, whether oridonin triggers eryptosis. Cytosolic Ca(2+)-concentration was estimated from Fluo3-fluorescence, cell volume from forward scatter in FACS analysis, phosphatidylserine exposure from binding of fluorescent annexin V, hemolysis from hemoglobin release, ATP concentration utilizing a luciferin-luciferase assay and ceramide abundance utilizing fluorescent anti-ceramide antibodies. A 48 h exposure to oridonin (≥25μM) significantly increased cytosolic Ca(2+)-concentration, increased ceramide formation, decreased forward scatter and triggered annexin V-binding (the latter in >20% of the erythrocytes). Oridonin didn't decrease ATP concentration and hemolysed <5% of erythrocytes. The effects of oridonin on annexin V binding were partially reversed in the nominal absence of Ca(2+) and by the addition of amiloride (1mM). The present observations reveal a completely novel effect of oridonin, i.e. triggering of Ca(2+) entry and ceramide formation as well as suicidal death of erythrocytes.
Collapse
Affiliation(s)
- Kashif Jilani
- Department of Physiology, University of Tuebingen, Gmelinstraße 5, D-72076 Tuebingen, Germany
| | | | | | | |
Collapse
|
37
|
Zelenak C, Föller M, Velic A, Krug K, Qadri SM, Viollet B, Lang F, Macek B. Proteome analysis of erythrocytes lacking AMP-activated protein kinase reveals a role of PAK2 kinase in eryptosis. J Proteome Res 2011; 10:1690-7. [PMID: 21214270 DOI: 10.1021/pr101004j] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Activation of AMP-activated protein kinase (AMPK) upon energy depletion stimulates energy production and limits energy utilization. Erythrocytes lacking AMPK are susceptible to suicidal cell death (eryptosis). A hallmark of eryptosis is cell membrane scrambling with phosphatidylserine exposure at the erythrocyte surface, which can be identified from annexin V-binding. AMPKα1-deficient mice (ampk(-/-)) suffer from anemia due to accelerated clearance of erythrocytes from circulating blood. To determine the link between AMPK and the eryptotic phenotype, we performed a global proteome analysis of erythrocytes from ampk(-/-) mice and wild-type mice using high-accuracy mass spectrometry and label-free quantitation and measured changes of expression levels of 812 proteins. Notably, the p21-activated kinase 2 (PAK2), previously implicated in apoptosis, was detected as downregulated in erythrocytes of ampk(-/-) mice, pointing to its potential role in eryptosis. To validate this, we showed that specific inactivation of PAK2 with the inhibitor IPA3 in human and murine ampk(+/+) erythrocytes increases the binding of annexin V and augments the stimulating effect of glucose deprivation on annexin V-binding. Inhibition of PAK2 failed to significantly modify annexin V-binding in ampk(-/-) erythrocytes, showing that AMPK and PAK2 exert similar phenotypes upon inactivation in erythrocytes. This study presents the first large-scale analysis of protein expression in erythrocytes from AMPKα1-deficient mice and reveals a role of PAK2 kinase in eryptosis.
Collapse
|
38
|
Alesutan I, Föller M, Sopjani M, Dërmaku-Sopjani M, Zelenak C, Fröhlich H, Velic A, Fraser S, Kemp BE, Seebohm G, Völkl H, Lang F. Inhibition of the heterotetrameric K+ channel KCNQ1/KCNE1 by the AMP-activated protein kinase. Mol Membr Biol 2011; 28:79-89. [PMID: 21231794 DOI: 10.3109/09687688.2010.520037] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The heterotetrameric K(+)-channel KCNQ1/KCNE1 is expressed in heart, skeletal muscle, liver and several epithelia including the renal proximal tubule. In the heart, it contributes to the repolarization of cardiomyocytes. The repolarization is impaired in ischemia. Ischemia stimulates the AMP-activated protein kinase (AMPK), a serine/threonine kinase, sensing energy depletion and stimulating several cellular mechanisms to enhance energy production and to limit energy utilization. AMPK has previously been shown to downregulate the epithelial Na(+) channel ENaC, an effect mediated by the ubiquitin ligase Nedd4-2. The present study explored whether AMPK regulates KCNQ1/KCNE1. To this end, cRNA encoding KCNQ1/KCNE1 was injected into Xenopus oocytes with and without additional injection of wild type AMPK (AMPKα1 + AMPKβ1 + AMPKγ1), of the constitutively active (γR70Q)AMPK (α1β1γ1(R70Q)), of the kinase dead mutant (αK45R)AMPK (α1(K45R)β1γ1), or of the ubiquitin ligase Nedd4-2. KCNQ1/KCNE1 activity was determined in two electrode voltage clamp experiments. Moreover, KCNQ1 abundance in the cell membrane was determined by immunostaining and subsequent confocal imaging. As a result, wild type and constitutively active AMPK significantly reduced KCNQ1/KCNE1-mediated currents and reduced KCNQ1 abundance in the cell membrane. Similarly, Nedd4-2 decreased KCNQ1/KCNE1-mediated currents and KCNQ1 protein abundance in the cell membrane. Activation of AMPK in isolated perfused proximal renal tubules by AICAR (10 mM) was followed by significant depolarization. In conclusion, AMPK is a potent regulator of KCNQ1/KCNE1.
Collapse
Affiliation(s)
- Ioana Alesutan
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|