Endothelial Dysfunction in Atherosclerotic Cardiovascular Diseases and Beyond: From Mechanism to Pharmacotherapies

Bacterial extracellular vesicles in the initiation, progression and treatment of atherosclerosis

Atherosclerosis is the primary cause of cardiovascular and cerebrovascular diseases. However, current anti-atherosclerosis drugs have shown conflicting therapeutic outcomes, thereby spurring the search for novel and effective treatments. Recent research indicates the crucial involvement of oral and gastrointestinal microbiota in atherosclerosis. While gut microbiota metabolites, such as choline derivatives, have been extensively studied and reviewed, emerging evidence suggests that bacterial extracellular vesicles (BEVs), which are membrane-derived lipid bilayers secreted by bacteria, also play a significant role in this process. However, the role of BEVs in host-microbiota interactions remains insufficiently explored. This review aims to elucidate the complex communication mediated by BEVs along the gut-heart axis. In this review, we summarize current knowledge on BEVs, with a specific focus on how pathogen-derived BEVs contribute to the promotion of atherosclerosis, as well as how BEVs from gut symbionts and probiotics may mitigate its progression. We also explore the potential and challenges associated with engineered BEVs in the prevention and treatment of atherosclerosis. Finally, we discuss the benefits and challenges of using BEVs in atherosclerosis diagnosis and treatment, and propose future research directions to address these issues.

Association between the difference in estimated GFR based on cystatin C versus creatinine in coronary artery diseases

BACKGROUND

The difference in estimated glomerular filtration rate (eGFR) derived from creatinine and cystatin C (eGFRdiff) has been noticed recently and the relationship with poor cardiovascular prognosis has been proven. However, primary prevention of the risk of coronary artery disease (CAD) is equally important but there is a lack of studies specifically investigating this implication.

METHODS

This prospective cohort study utilized data from the UK Biobank, including 437,536 participants without CAD at baseline. The primary outcome was defined as CAD. The eGFRdiff was calculated by subtracting creatinine-based eGFR from cystatin C-based eGFR. Participants were then categorized into a negative, intermediate range, and positive group based on thresholds of -15 mL/min/1.73 m2 and 15 mL/min/1.73 m2. Cox proportional risk models were used to evaluate the associations of eGFRdiff with CAD and the relationship among different genetic risks of CAD.

RESULTS

During a median follow-up of 13.8 years, CAD occurred in 36,797 participants. In the fully adjusted model, compared to midrange eGFRdiff, participants with a positive eGFRdiff had a lower risk of CAD (HR 0.717, 95%CI 0.675-0.762), while with a negative eGFRdiff had a higher risk (HR 1.433, 95%CI 1.399-1.468). When eGFRdiff was treated as a continuous variable, a statistically significant trend toward a lower risk of CAD as eGFRdiff increased (HR 0.982, 95% CI 0.981-0.982). Moreover, this relationship is independent of genetic susceptibility.

CONCLUSIONS

eGFRdiff was associated with CAD risk, where a high eGFRdiff corresponded to a decreased likelihood of CAD onset no matter genetic susceptibility.

Downregulation of miR-27a-3p induces endothelial injury and senescence and its significance in the development of coronary heart disease

miR-27a-3p is a multifunctional miRNA that plays a critical role in the process of angiogenesis. However, its specific effect on coronary heart disease (CHD), particularly on the regulation of downstream molecules and the resulting impact on endothelial cell injury, has not yet been fully elucidated. This study aimed to explore the relationship between miR-27a-3p and CHD and its underlying mechanical molecular pathways in CHD patients and modeled endothelial cells with techniques such as RT-qPCR, RNA sequencing and bioinformatics. Consequently, the expression of miR-27a-3p was significantly decreased in CHD patients. In endothelial cells, overexpression of miR-27a-3p was observed to decrease malonaldehyde, gamma H2A histone family member X and interleukin 6 while increased superoxide dismutase, thus reduced endothelial injury and senescence. RNA sequencing and bioinformatics revealed glutamate ionotropic receptor NMDA type subunit 2D (GRIN2D) as a target gene of miR-27a-3p, and dual luciferase assays confirmed the direct binding of miR-27a-3p to the 3'UTR of GRIN2D. Subsequent validation experiments demonstrated that miR-27a-3p inhibited the protein expression of GRIN2D and PKC and suppressed the activation of the MAPK/ERK signaling pathway by reduced downstream MEK and ERK phosphorylation, leading to enhanced endothelial apoptosis. In conclusion, miR-27a-3p played a crucial role in regulating endothelial cell dysfunction which may trigger coronary atherosclerosis and CHD by targeting GRIN2D in the PKC/MEK/ERK signaling pathway.

The miR-21-5p/DUSP8/MAPK signaling pathway mediates inflammation and apoptosis in vascular endothelial cells induced by intermittent hypoxia and contributes to the protective effects of N-acetylcysteine

Obstructive sleep apnoea hypopnea syndrome (OSAHS) is a sleep disorder associated with significant cardiovascular complications, characterized by intermittent hypoxia (IH). IH causes endothelial dysfunction, an early event in cardiovascular disease. We investigated the role of dual-specificity phosphatase 8 (DUSP8), a key negative regulator of the mitogen-activated protein kinase (MAPK) signalling pathway, in IH-induced endothelial cell damage, and the therapeutic effects of N-acetylcysteine (NAC) by establishing IH models in human umbilical vein endothelial cells and C57BL/6 mice. DUSP8 and MAPK signalling pathway-related proteins were analysed by western blotting, and DUSP8 mRNA and miR-21-5p expression was assessed by RT-qPCR. Inflammatory cytokines were detected by an enzyme-linked immunosorbent assay, apoptosis-related proteins were analysed by western blotting, and apoptosis was assessed using flow cytometry. IH stimulation induced inflammation and apoptosis in endothelial cells, downregulated DUSP8 expression, and upregulated the phosphorylation of key molecules involved in the MAPK signalling pathway. However, DUSP8 overexpression alleviated IH-induced inflammation and apoptosis in endothelial cells and reduced the phosphorylation of key molecules in the MAPK signalling pathway. Bioinformatic analysis and dual-luciferase reporter assays confirmed that DUSP8 is a direct target of miR-21-5p. DUSP8 overexpression effectively reversed the damage caused by miR-21-5p upregulation under IH conditions. Furthermore, in cell and animal models of IH, NAC demonstrated protective effects against inflammation, apoptosis, and oxidative stress through a mechanism linked to the miR-21-5p/DUSP8/MAPK signalling pathway. Overall, this study elucidated the protective role of DUSP8 against IH-induced endothelial injury and confirmed the potential of NAC as a therapeutic agent for OSAHS-related diseases.

Targeting endothelial cells: A novel strategy for pulmonary fibrosis treatment

Endothelial cells (ECs) are a monolayer of flat cells lining the inner surfaces of blood and lymphatic vessels. They play a key role in many physiological and pathological processes. Specifically, they maintain vascular permeability and structural stability and participate in immune responses, inflammation, coagulation, and other vital functions. ECs play a decisive role in various age-related diseases; however, their involvement in pulmonary fibrosis (PF) remains poorly understood. PF refers to a group of chronic interstitial lung diseases characterised by progressive scarring of the pulmonary parenchyma, primarily caused by aberrant tissue repair mechanisms. These changes lead to irreversible loss of lung function. Although the exact pathophysiological mechanism underlying PF has not yet been elucidated, recent studies have indicated that ECs may play a pivotal role in PF. This review outlines the involvement of pulmonary vascular ECs in PF, focusing on the regulation of vascular remodelling and endothelial barrier integrity and on the maintenance of angiogenesis through EC-specific markers, such as vascular endothelial growth factor. This review also explores processes such as endothelial-to-mesenchymal transition, immune cell interactions, anti-EC antibody reactions, metabolic dysregulation, and cellular senescence. By elucidating recent advancements in understanding the role of ECs in PF and examining drugs targeting ECs for the treatment of PF, this study provides novel insights into the pathological mechanisms of PF and the development of endothelium-based therapeutic agents.

Vascular actions of Ang 1-7 and Ang 1-8 through EDRFs and EDHFs in non-diabetes and diabetes mellitus

The renin-angiotensin system (RAS) plays a pivotal role in regulating vascular homeostasis, while angiotensin 1-8 (Ang 1-8) traditionally dominates as a vasoconstrictor factor. However, the discovery of angiotensin 1-7 (Ang 1-7) and Ang 1-8 has revealed counter-regulatory mechanisms mediated through endothelial-derived relaxing factors (EDRFs) and endothelial-derived hyperpolarizing factors (EDHFs). This review delves into the vascular actions of Ang 1-7 and Ang 1-8 in both non-diabetes mellitus (non-DM) and diabetes mellitus (DM) conditions, highlighting their effects on vascular endothelial cell (VECs) function as well. In a non-DM vasculature context, Ang 1-8 demonstrate dual effect including vasoconstriction and vasodilation, respectively. Additionally, Ang 1-7 induces vasodilation upon nitric oxide (NO) production as a prominent EDRFs in distinct mechanisms. Further research elucidating the precise mechanisms underlying the vascular actions of Ang 1-7 and Ang 1-8 in DM will facilitate the development of tailored therapeutic interventions aimed at preserving vascular health and preventing cardiovascular complications.

Endothelial Krüppel-like factor 2/4: Regulation and function in cardiovascular diseases

This review presents an overview of the regulation, function, disease-relevance and pharmacological regulation of the critical endothelial transcription factors KLF2/4 in vasculature. The regulatory mechanisms of KLF2/4 expression and activity in vascular endothelium in response to hemodynamic forces and biochemical stimuli are depicted. The functional effects mediated by direct or indirect target genes of KLF2/4 in endothelial cells are systematically summarized. The contributory roles that dysregulated KLF2/4 play in relevant cardiovascular pathologies, such as atherosclerotic vascular lesions, pulmonary arterial hypertension and vascular complications of diabetes were reviewed. Moreover, this review also discusses the pharmacological regulation of KLF2/4 by drugs used in clinics and therapeutic possibility by directly targeting these two transcription factors for treating atherosclerotic cardiovascular diseases. Finally, prospective opinions on the gaps in disclosing novel vascular function mediated by KLF2/4 and future research needs are expressed.

Spectrum-effect relationship of the cardiovascular-protective effect of with Chrysanthemi Flos by UPLC-MS/MS and component knock-out method

Chrysanthemi Flos (CF), as one of the important 'dual-use' plants, possesses great pharmacological research and development potential. This work aimed to find the pharmacodynamic material basis of CF in cardiovascular-protection by spectrum-effect relationship and component knock-out method. The fingerprint was established by ultra-high performance liquid chromatography and 25 peaks were picked out as common peaks. The common peaks were identified by ultra-performance liquid chromatography-quadrupole-orbitrap-mass spectrometry including twelve flavonoids, nine phenylpropanoids, three organic acids, and one nucleoside. The cardiovascular-protective effect of CF was determined by angiotensin II-induced injury model of human umbilical vein endothelial cells. Grey relation analysis, partial least squares regression analysis and Pearson's correlation analysis were performed to assess the relationship between the cardiovascular-protective effect and ingredients. Spectrum-effect relationship and component knock-out method revealed that P11 (luteolin-7-O-β-D-glucoside), P14 (3,4-O-dicaffeoylquinic acid), P16 (1,5-O-dicaffeoylquinic acid), and P17 (3,5-O-dicaffeoylquinic acid) were the pharmacological material basis for the cardiovascular-protective effect of CF. This work preliminarily elucidated the pharmacodynamic material basis of cardiovascular-protective effect of CF, which could be used to considerable methods and insight for the fundamental research of the pharmacodynamic material basis of Traditional Chinese Medicine.

Activating TRPV1 by evodiamine attenuates atherosclerosis by inhibiting endothelial microparticle release

Endothelial microparticles (EMPs) were known as the biomarker of endothelial dysfunction, which could initiate atherosclerosis(AS). The traditional chinese medicine Evodiae and its main alkaloid component, evodiamine, exerts anti-atherosclerosis effects through transient receptor potential vanilloid type 1(TRPV1). However, it is unclear whether the anti-atherosclerosis effect of evodiamine is related to the generation of EMPs. The present study aims to investigate the anti-atherosclerosis effect of evodiamine and the underlying mechanism of the formation and release of EMPs. To establish the AS mice model, ApoE-/- mice were fed a high-fat diet for eight weeks. Histopathology results were evaluated using hematoxylin and eosin staining. The quantity of EMPs was examined by flow cytometry. Serum lipid and cytokines levels were assessed by ELISA kits, and protein expression was determined by Western blotting. We found that evodiamine decreased the plasma EMPs levels, reduced the lipid levels, IL-6 and ET-1 levels, and reduced the size of atherosclerotic lesions in ApoE-/- mice significantly. Moreover, evodiamine significantly down-regulated the expression levels of ROCK, which was involved in the release of EMPs. In contrast, pre-treatment with capsazepine (the blocker of TRPV1) abrogated these effects of evodiamine. In vitro, lipopolysaccharide was used to induce the release of EMPs in the human aortic endothelial cells(HAECs). Consistently silencing the expression of TRPV1 in the cells through siRNA interference resulted in an elevation of EMPs levels and the expression of ROCK. In conclusion, activating TRPV1 by evodiamine may inhibit the activation of ROCK and then decrease the release of EMPs, relieve the inflammation of the endothelial cells, and finally attenuate the development of atherosclerosis.

Role of Inflammatory and Proresolving Mediators in Endothelial Dysfunction

Excessive local inflammation is a common mechanism in many cardiovascular diseases (CVDs) such as hypertension, atherosclerosis and aortic aneurysms. In endothelial cells, inflammatory cytokines such as interferons, tumour necrosis factor alpha or interleukins increase oxidative stress and contractile prostanoids and the expression of adhesion molecules that reduce nitric oxide (NO) availability and bind leucocytes, thereby impairing endothelial function. Despite this evidence, anti-inflammatory therapies are not yet indicated for the treatment of most CVD. Resolution of inflammation is mediated by a family of specialized pro-resolving mediators (SPMs) that act on cognate G protein-coupled receptors to limit immune cell infiltration and initiate tissue repair. SPMs, generated from omega-3 and omega-6 polyunsaturated fatty acids, belong to four major families: lipoxins, resolvins, protectins and maresins. SPM receptors are expressed in immune and vascular cells where they regulate important processes such as phagocytosis and polarization, production of cytokines, NO and prostacyclin, and modulation of smooth muscle cell phenotype. Growing evidence in animal models demonstrates that activation of SPM receptors can protect vascular function and structure and provide beneficial effects in various CVD. We will review recent advances in the role of inflammation and SPMs in vascular (dys)function in hypertension, atherosclerosis, and aortic aneurysms.

Accelerating inflammatory resolution in humans to improve endothelial function and vascular health: Targeting the non-canonical pathway for NO

BACKGROUND

Chronic cardiovascular diseases (CVD) are characterised by low-grade systemic inflammation in part due to reduced nitric oxide (NO) bioavailability associated with endothelial dysfunction. Bioavailability of NO can be enhanced by activation of the non-canonical pathway, through increased dietary inorganic nitrate consumption with the potential to attenuate inflammation.

METHODS

We sought to determine whether dietary inorganic nitrate influences the inflammatory response in models of localised (cantharidin-induced blisters) and systemic inflammation (typhoid vaccine), in healthy male volunteers and conducted two clinical trials; Blister-NITRATE and Typhoid-NITRATE respectively.

RESULTS

We show that dietary nitrate attenuates endothelial dysfunction following typhoid vaccine administration and accelerates resolution of cantharidin-induced blisters. Both phenomena were associated with an increased level of pro-resolving mediators consequent to a reduction in the expression and activity of pro-inflammatory monocytes. Moreover, we show that leukocytes of the monocyte lineage express the nitrite reductase XOR, that may drive localised nitrite reduction to elevate NO (and cGMP) to drive the protective phenotype.

CONCLUSIONS

Inorganic nitrate improves endothelial function in the setting of systemic inflammation. Whilst the immediate inflammatory response appeared unaffected by inorganic nitrate treatment, during the resolution phase of the acute inflammatory response lower levels of pro-inflammatory classical inflammatory and intermediate monocytes and attenuated levels of inflammatory cytokines and chemokines were evident. We propose that this reflects a pro-resolution phenotype that may be of potential therapeutic benefit in patients with established CVD.

CLINICAL TRIAL REGISTRATION

URL: https://www.

CLINICALTRIALS

gov; unique identifiers NCT02715635, NCT03183830.

A retrospective study on the correlation between antibody levels and endothelial function in SLE patients: An analysis based on ultrasound and serum biomarkers

BACKGROUND

Systemic lupus erythematosus (SLE) was a complex autoimmune disease characterized by a spectrum of clinical and immunological manifestations, with cardiovascular disease (CVD) being a leading cause of morbidity and mortality. Endothelial dysfunction was critical in the pathogenesis of atherosclerosis and other cardiovascular complications in SLE. This study aimed to investigate the correlation between autoantibody levels and endothelial function in SLE patients using ultrasound and serum biomarkers.

METHODS

A retrospective case-control study was conducted with 317 SLE patients treated from December 2021 to December 2023. Patients were categorized based on Flow-Mediated Dilation (FMD) values into an abnormal endothelial function group (n = 191) and a normal function group (n = 126). Serum biomarkers, including soluble thrombomodulin (sTM), von Willebrand factor (vWF), and soluble vascular cell adhesion molecule-1 (sVCAM-1), were assessed. Autoantibody levels were measured using enzyme-linked immunosorbent assays for anti-double stranded DNA (anti-dsDNA), anti-Smith, and anticardiolipin antibodies levels. Statistical analyses, including correlation and logistic regression, were performed to determine associations between antibody levels and endothelial function.

RESULTS

Higher levels of Anti-Smith were significantly associated with poorer endothelial function, while higher Anti-dsDNA levels were positive correlated with endothelial function (Anti-Smith: coefficient = -0.168, Std_Error = 0.027, t_value = -6.228, P < 0.001; Anti-dsDNA: coefficient = 0.140, Std_Error = 0.022, t_value = 6.345, P < 0.001). These results underscore the importance of antibody levels in assessing endothelial health.

CONCLUSION

This study highlights the intricate relationship between specific autoantibodies and endothelial dysfunction in SLE patients. Elevated sVCAM-1 and Anti-Smith levels were associated with a higher risk of endothelial impairment, whereas Anti-dsDNA antibodies showed a positively correlated better endothelial function.

High-density lipoprotein-based nanoplatforms for macrophage-targeted diagnosis and therapy of atherosclerosis

Atherosclerosis, the primary cause of cardiovascular disease, which has the highest mortality worldwide, is a chronic inflammatory disease mainly induced by excessive lipid accumulation in plaque macrophages. Lipid-laden macrophages are crucial at all stages of atherosclerotic lesion progression and are, thus, regarded as popular therapeutic targets for atherosclerosis. High-density lipoprotein (HDL), an endogenous particle with excellent atherosclerotic plaque-homing properties, is considered a potential therapeutic agent for treating atherosclerosis. Based on the excellent properties of HDL, reconstituted HDL (rHDL), with physiological functions similar to those of its natural counterparts, have been successfully prepared as therapeutics and are also recognized as a potential nanoplatform for delivering drugs or contrast agents to atherosclerotic plaques owing to their high biocompatibility, amphiphilic structure, and macrophage-targeting capability. In this review, we focus on the (a) important role of macrophages in atherosclerotic lesions, (b) biological properties of rHDL as a delivery nanoplatform in atherosclerotic diseases, and (c) multiple applications of rHDL in the diagnosis and treatment of atherosclerosis. We systematically summarize the novel applications of rHDL with unique advantages in atherosclerosis, aiming to provide specific insights and inspire additional innovative research in this field.

A self-sacrificing anti-inflammatory coating promotes simultaneous cardiovascular repair and reendothelialization of implanted devices

During interventional surgeries of implantable cardiovascular devices in addressing cardiovascular diseases (CVD), the inevitable tissue damage will trigger host inflammation and vascular lumen injury, leading to delayed re-endothelization and intimal hyperplasia. Endowing cardiovascular implants with anti-inflammatory and endothelialization functions is conducive to the target site, offering significant tissue repair and regeneration benefits. Herein, inspired by the snake's molting process, a ShedWise device was developed by using the poly(propylene fumarate) polyurethane (PPFU) as the foundational material, which was clicked with hyperbranched polylysine (HBPL) and followed by conjugation with pro-endothelial functional Arg-Glu-Asp-Val peptide (REDV), and finally coated with a "self-sacrificing" layer having reactive oxygen species (ROS)-scavenging ability and degradability. During the acute inflammation in the initial stage of implantation, the ROS-responsive hyperbranched poly(acrylate-capped thioketone-containing ethylene glycol (HBPAK) coating effectively modulated the level of environmental inflammation and resisted initial protein adsorption, showcasing robust tissue protection. As the coating gradually "sacrificed", the exposed hyperbranched HBPL-REDV layer recruited specifically endothelial cells and promoted surface endothelialization. In a rat vascular injury model, the ShedWise demonstrated remarkable efficiency in reducing vascular restenosis, protecting the injured tissue, and fostering re-endothelization of the target site. This innovative design will introduce a novel strategy for surface engineering of cardiovascular implants and other medical devices.

Effects of Pomegranate on Vascular Endothelial Function: A Systematic Review and Meta-Analysis of Clinical Trials

OBJECTIVE

In this systematic review and meta-analysis of clinical trials, we investigated the effect of pomegranate on vascular endothelial function markers.

METHODS

We searched PubMed, Scopus, Web of Science, and the Cochrane Library until September 2024. Clinical trials that investigated the effect of pomegranate juice, extract, or its components on markers of vascular endothelial function, including flow-mediated dilation (FMD), intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), E-selectin, nitric oxide (NO), interleukin 6 (IL-6), IL-1, and IL-10, in healthy or diseased adults ages ≥ 18 years were eligible to be included. The quality of studies was assessed using the Cochrane tool. Random-effects meta-analysis was used to pool standardized mean differences (SMD) and 95% CI for the outcomes assessed by at least three studies.

RESULTS

Nineteen studies were included. Analysis of studies indicated a nonsignificant effect on VCAM-1 (SMD: -041, 95%CI: -2.53 to 1.71, I2= 83.6%, n = 3), while a significant reduction in ICAM-1 was observed (SMD: -0.63, 95% CI: -0.85 to -0.40, I2 = 0.0%, n = 3). Pooled analysis of fourteen studies on IL-6 indicated a significant reduction (-0.58, 95% CI: -0.98 to -0.19, I2 = 82.63%). The results of the three studies on E-selectin were inconsistent. The FMD and NO were assessed in only one study.

CONCLUSIONS

Pomegranate is effective in improving IL-6 and ICAM-1, but not VCAM-1.

LINC00926, Regulated by TCF12, Modulates the Ubiquitination of GPX4 to Regulate Ferroptosis by Interacting with STUB1 in HUVECs

LINC00926 has been identified as an upregulated lncRNA in patients with coronary heart disease (CHD) through high-throughput sequencing. This study aimed to explore the biological role of LINC00926 in vascular endothelial cell ferroptosis and its underlying mechanisms. For in vitro experiments, HUVECs were exposed to hypoxic conditions. Our results showed an upregulation of LINC00926 expression, a decrease in GPX4 and GSH levels, and an increase in MDA and ROS levels in hypoxia-treated HUVECs. Furthermore, the ferroptosis inhibitor (ferrostatin-1) reversed the decrease in cell viability induced by hypoxia, suggesting that hypoxia treatment triggered GPX4-mediated ferroptosis in HUVECs. These variations were further exacerbated when LINC00926 was overexpressed, but were partially mitigated when LINC00926 was silenced. Notably, LINC00926 had no effect on GPX4 mRNA levels. Our data proved that LINC00926 modulated the ubiquitination and degradation of GPX4 via STUB1, thereby promoting hypoxia-induced HUVEC ferroptosis. Additionally, ChIP and luciferase reporter gene assays confirmed that TCF12 protein enhanced the transcriptional activity of LINC00926 promoter, hinting TCF12 is an upstream regulator of LINC00926. Besides, LINC00926 also enhanced the stability of TCF12 mRNA to promote TCF12 expression. Moreover, TCF12 acted as a regulator of ferroptosis in hypoxia-induced HUVECs. Finally, rescue experiments determined the role of the TCF12/LINC00926/GPX4 axis in ferroptosis of HUVECs upon hypoxic stimulation. In conclusion, this study demonstrated that the TCF12/LINC00926/GPX4 axis plays a regulatory role in hypoxia-induced ferroptosis of HUVECs, offering a promising target for the treatment of CHD.

Ant Colony-Inspired Adaptive Peptide Nanoregulators Remodeling the Endothelial Barrier to Alleviate Inflammatory Responses

Endothelial barrier disruption exacerbates inflammation and tissue injury, posing dual challenges of reconstructing tight junctions and precisely regulating the local microenvironment. Traditional multidrug therapies often struggle with rapid drug leakage due to barrier dysfunction and limited synergy between therapeutic agents. Here, a strategy is proposed inspired by the "ant colony collaboration", developing an "all-in-one" conformationally adaptive peptide nanoregulator (VJP NPs) through the intelligent integration of three functional peptides. VJP NPs strategically harness the overexpression of vascular cell adhesion protein 1 (VCAM-1), enabling selective targeting of the inflamed endothelium under the guidance of the VHPK peptide while accumulating within the inflammatory microenvironment. The nanoregulators disassemble in response to high ROS levels, efficiently scavenging excess ROS. Simultaneously, they release the PMX peptide, competitively binding to the complement receptor C5aR to regulate the complement cascade. Furthermore, they release the JIP peptide to restore the endothelial barrier, reducing immune cell infiltration. As demonstrated in a mouse model of acute lung injury (ALI), VJP NPs markedly promote pulmonary vascular endothelial barrier repair, effectively attenuating inflammatory responses and alleviating tissue injury. This peptide-based nanoplatform boosts peptide delivery efficiency via a nanoprodrug strategy and amplifies synergistic therapeutic effects, highlighting its potential in endothelial barrier restoration and inflammation modulation.

Therapeutic potential of natural flavonoids in atherosclerosis through endothelium-protective mechanisms: An update

Atherosclerosis and its associated cardiovascular complications remain significant global public health challenges, underscoring the urgent need for effective therapeutic strategies. Endothelial cells are critical for maintaining vascular health and homeostasis, and their dysfunction is a key contributor to the initiation and progression of atherosclerosis. Targeting endothelial dysfunction has, therefore, emerged as a promising approach for the prevention and management of atherosclerosis. Among natural products, flavonoids, a diverse class of plant-derived phenolic compounds, have garnered significant attention for their anti-atherosclerotic properties. A growing body of evidence demonstrates that flavonoids can mitigate endothelial dysfunction, highlighting their potential as endothelial dysfunction-targeted therapeutics for atherosclerosis. In this review, we summarize current knowledge on the roles of natural flavonoids in modulating various aspects of endothelial dysfunction and their therapeutic effects on atherosclerosis, focusing on the underlying molecular mechanisms. We also discuss the challenges and future prospects of translating natural flavonoids into clinical applications for cardiovascular medicine. This review aims to provide critical insights to advance the development of novel endothelium-protective pharmacotherapies for atherosclerosis.

Fisetin Clears Senescent Cells Through the Pi3k-Akt-Bcl-2/Bcl-xl Pathway to Alleviate Diabetic Aortic Aging

Vascular aging is a major contributor to age-related cardiovascular diseases (CVDs) and type 2 diabetes mellitus (T2DM) induced early arterial aging and excessive senescent cells (SCs) burden in vessels. Inhibiting cellular senescence or eliminating SCs could effectively improve aging-related CVDs. Fisetin, a flavonoid extracted from cotinus coggygria scop, has shown potential in alleviating aging by clearing SCs. This study investigated the unexplored mechanisms and efficacy of fisetin in alleviating T2DM-related aortic aging. The T2DM mouse model was induced using a high-fat diet and low-dose streptozotocin injection. Chronic fisetin treatment's protective effects against aortic aging were assessed via senescence-associated beta-galactosidase (SA-β-Gal) staining, histopathology, and vasomotor function. RNA-sequencing and western blotting identified relevant signaling pathways and protein expression. Fisetin's effects on SCs and senescence-associated secretory phenotype (SASP) factors were evaluated through cell viability, apoptosis, and co-culture assays. Docking simulations suggested fisetin as a potential Phosphoinositide 3-kinase (Pi3k) inhibitor. In vivo, chronic fisetin treatment reduced aortic SCs burden, alleviating T2DM-related and natural aortic aging. In vitro, fisetin selectively induced apoptosis of senescent endothelial cells via regulating the Pi3k-Protein Kinase B (Akt)-B-cell lymphoma (Bcl)-2/Bcl-xl pathway and suppressed SASP and its detrimental effects. Furthermore, fisetin combined with metformin therapy showed superior anti-aging effects on T2DM-related aortic aging compared to metformin monotherapy. In conclusion, chronic fisetin treatment alleviates T2DM-related aortic aging via clearing the SCs burden and abrogating the SASP factors. Fisetin combined with metformin therapy might be a potential therapeutic strategy for T2DM-related CVDs.

Diabetes Mellitus and Associated Vascular Disease: Pathogenesis, Complications, and Evolving Treatments

Diabetes mellitus is a metabolic disorder, characterized by elevated blood sugar levels (hyperglycemia) and insulin dysregulation. This disease is associated with morbidity and mortality, including significant potential vascular complications. High levels of hyperglycemia lead to not only elevated levels of reactive oxygen species but also advanced glycation end products, which are detrimental to the vascular endothelium and reduce protective compounds such as nitric oxide and prostacyclin. This damage contributes to the development of both macrovascular and microvascular complications. The present investigation explores the pathophysiological mechanisms of diabetic vascular complications and evaluates current management strategies, including lifestyle modifications, pharmacological treatments, and emerging therapies. The review underscores the importance of ongoing progress in diabetes management and patient education to lead to optimal patient-health outcomes and quality of life for individuals with diabetes mellitus.

IL-6 Affects Liver Metabolic Abnormalities Caused by Silicon Exposure by Regulating the PKC/YY1 Signaling Pathway

BACKGROUND

This study aims to investigate the impact of coal dust (silicon dioxide) exposure on dyslipidemia and its underlying mechanisms, with a focus on the association between coal dust exposure and hepatic metabolic disorders.

METHODS

Clinical data were collected from 5433 coal mine workers to compare the incidence of dyslipidemia between the dust-exposed group and the non-exposed group. A mouse model of silicon dioxide exposure was established to observe hepatic fat accumulation and pathological changes. Liver tissue sequencing was performed to screen for key differential genes. In vitro cell experiments were utilized to identify the molecular mechanisms underlying hepatocyte metabolic abnormalities induced by silicon dioxide exposure.

RESULTS

Clinical data revealed that 69.2% of miners in the dust-exposed group developed dyslipidemia, which was higher than the 30.7% in the non-exposed group. Animal data showed that silicon dioxide exposure led to hepatic fat deposition and pathological damage, with the degree of injury positively correlated with exposure time. Liver sequencing identified a significant upregulation of the FMO3 (flavin monooxygenase 3) gene in mouse liver tissue following silicon dioxide exposure, accompanied by enhanced inflammatory responses. Mechanistic studies demonstrated that silicon dioxide activates Kupffer cells to secrete IL-6 (interleukin-6), which induces high expression of FMO3 in hepatocytes through the PKC/YY1 signaling pathway, thereby disrupting lipid metabolism.

CONCLUSIONS

Silicon dioxide exposure can promote the upregulation of FMO3 expression in hepatocytes by activating Kupffer cells to release IL-6 via the PKC/YY1 pathway, ultimately leading to lipid metabolic disorders and dyslipidemia.

Progress in the study of the mechanism of ferroptosis in coronary heart disease and clinical intervention strategies

Coronary heart disease (CHD), a serious cardiovascular condition with complex and diverse pathogenesis, has recently seen increased attention to the role of ferroptosis-a novel iron-dependent form of programmed cell death. This review synthesizes current research on ferroptosis mechanisms in CHD and emerging clinical intervention strategies. Ferroptosis is characterized by dysregulated iron metabolism, lipid peroxidation, and reactive oxygen species (ROS) accumulation, processes intimately linked to CHD pathophysiology. Under ischemic and hypoxic conditions commonly seen in coronary artery disease (CAD), cardiomyocytes become particularly susceptible to ferroptosis, resulting in cellular dysfunction and diminished cardiac performance. Mechanistic studies have revealed that altered expression of iron metabolism-related proteins (including GPX4, FTH1, TfR1, and HO-1), accumulation of lipid peroxidation products, and disruption of antioxidant defense systems (particularly the Nrf2/GPX4 pathway) are central to ferroptosis progression in cardiac tissue. Clinically, both specific ferroptosis inhibitors (such as Ferrostatin-1) and traditional medicine components (such as Puerarin) have emerged as promising therapeutic candidates, showing cardioprotective effects in experimental models. However, research into ferroptosis mechanisms in CHD remains in its early stages, with significant questions regarding its relationship with other cell death pathways and the clinical efficacy of ferroptosis-targeting interventions requiring further investigation. Future research directions should include in-depth mechanistic exploration and the development of more effective, safer clinical interventions targeting the ferroptosis pathway in cardiovascular disease.

The association of non-exercise estimated cardiorespiratory fitness with hypertension and all-cause mortality in American and Chinese populations: evidence from NHANES and CHARLS

Background

The Non-Exercise Estimated Cardiorespiratory Fitness (NEE-CRF) method has gained attention in recent years due to its simplicity and effectiveness. Hypertension and all-cause mortality are significant public health issues worldwide, highlighting the importance of exploring the association between NEE-CRF and these two conditions.

Methods

The data from the National Health and Nutrition Examination Survey (NHANES) and the China Health and Retirement Longitudinal Study (CHARLS) were utilized to validate the association between NEE-CRF and hypertension as well as all-cause mortality. NEE-CRF was calculated using a sex-specific longitudinal non-exercise equation. To investigate the relationship between hypertension and all-cause mortality, multivariable regression analysis, generalized additive models, smooth curve fittings, and threshold effect analysis were employed. Logistic regression was used for hypertension analysis, while Cox proportional hazards regression was applied for all-cause mortality. Additionally, we conducted stratified analyses and interaction tests among different groups.

Results

In the NHANES, after fully adjusting for covariates, each unit increase in NEE-CRF was associated with a 24% reduction in the risk of hypertension (OR: 0.76, 95% CI: 0.74-0.78) and a 12% reduction in the risk of all-cause mortality (HR: 0.88, 95% CI: 0.79-0.86). Subgroup analyses showed that the relationship between NEE-CRF and both hypertension and all-cause mortality remained negatively correlated across different subgroups. The negative association was also validated in the CHARLS.

Conclusions

Higher NEE-CRF levels may reduce the risk of developing hypertension and all-cause mortality.

Novel mechanism of fluoride induced cardiovascular system injury by regulating p53/miR200c-3p during endothelial dysfunction

BACKGROUND

The impairment of the cardiovascular system by fluoride has attracted public health concern, and its toxic effects on ECs have garnered extensive research attention. However, epidemiological clues of fluoride induced cardiovascular injury are limited. The function of ECs is crucial for the early diagnosis of CVD, yet mechanisms through which fluoride disrupts endothelial function are still unclear.

PURPOSE

To investigate the relationship between fluoride exposure and hypertension in population by epidemiological investigation. To explore the potential mechanism of functional injury of ECs induced by fluoride.

RESULT

Epidemiological studies have shown that the risk of hypertension in study population increased with the increased of urinary fluoride concentration [OR = 1.565, 95%CI (1.143, 2.142)]. In rat model with fluorosis alongside a model of fluoride induced ECs injury, NaF led to anti-adhesion of ECs and barrier dysfunction. Notably, the expression levels of eNOS and NO were found to be decreased, while the expression levels of ACE, vWF, ICAM-1, VCAM-1 and ET-1 were elevated. Our findings also indicated that NaF induced oxidative stress in ECs, evidenced by significant increased in ROS and MDA levels and decreased protein expression of GPx4 and SOD activity. It was further found that NaF activated the p53/miR-200c-3p signaling axis via ROS, leading to endothelial dysfunction.

CONCLUSION

This study found that fluoride exposure was a risk factor for hypertension. In addition, fluoride could cause ECs dysfunction by inducing oxidative stress and activating p53/miR-200c-3p. These findings were helpful to further understand the mechanism of fluoride induced cardiovascular system injury and provide a theoretical basis for fluoride induced cardiovascular system injury.

Vascular cell types in progeria: victims or villains?

Hutchinson-Gilford progeria syndrome (HGPS) is an ultrarare genetic disease caused by progerin, a broadly expressed mutant variant of lamin A protein that accelerates aging and leads to premature death typically in adolescence. Progerin affects many organs and reproduces many characteristics of physiological aging, with the main cause of death in HGPS being atherosclerotic cardiovascular disease (CVD). Due to the rarity of HGPS, advances in understanding the disease and progress toward new therapeutic approaches are crucially dependent on preclinical models. We discuss recent research developments from a variety of HGPS experimental systems, with a special focus on in vivo studies of the role of vascular smooth muscle cells (VSMCs) and endothelial cells (ECs) that are key players in atherosclerosis.

The sprouting angiogenesis and vascular dysfunction triggered by bisphenol S and tetrabromobisphenol S through disrupting vascular endothelial-cadherin in zebrafish

Exogenous chemical toxicants may be important inducers of pathological angiogenesis diseases. However, few studies have investigated the associations between pathological angiogenesis diseases and chemical toxicant exposures, and the specific mechanism by which chemical toxicants induce sprouting angiogenesis is unclear. In this study, zebrafish were exposed to bisphenol S (BPS, 1-100 μg/L) and tetrabromobisphenol S (TBBPS, 0.1 and 10 μg/L) from the embryonic stage to the larval stage to investigate how pollutants interfere with angiogenesis and the function of ectopic sprouting vessels. The results showed that BPS and TBBPS promoted ectopic sprouting angiogenesis in different types of vascular plexuses, including the posterior cardinal vein (PCV) and superficial choroidal vessels (SOVs), at different developmental time points. Proteomic analyses of eGFP-positive endothelial cells (ECs) isolated from Tg(flk1: eGFP) zebrafish revealed that both BPS and TBBPS induced ectopic angiogenesis by acting on vascular endothelial-cadherin (VE-cadherin) and activating downstream proangiogenic signaling. In ectopic sprouting vessels induced by BPS and TBBPS, increased endothelial permeability resulted in white blood cell recruitment. Human oxidized lipids also tended to deposit in these ectopic vessels following BPS and TBBPS exposure. These findings suggest that chemical toxicant-induced ectopic angiogenesis is an important cause of vascular dysfunction and related diseases.

The integration of scRNA-seq with microarray and in-vivo experiments facilitates a comprehensive elucidation of the molecular mechanisms underlying endothelial cell involvement in myocardial infarction

Myocardial infarction (MI) remains a major global health challenge, with endothelial cell function playing a crucial role in its progression. Advances in single-cell RNA sequencing (scRNA-seq) have enhanced our understanding of MI pathogenesis. This study aims to identify key genes within endothelial cells using scRNA-seq data and validate them through microarray data and in vivo models elucidate their role in the progression of MI. ScRNA-seq and microarray datasets relevant to MI were obtained from the GEO database. The Seurat package was used for data pre-processing and marker gene identification. Endothelial cell subpopulations were characterised using the hdWGCNA package, while intercellular interactions with fibroblasts were assessed using CellChat. Key genes were identified using comprehensive bioinformatics techniques such as scCODE, FindMarkers and protein-protein interaction (PPI) analysis, with validation from microarray data and in vivo experiments (WB, qPCR, immunofluorescence) in the model of MI. The analysis via scRNA-seq revealed 16 distinct cell clusters encompassing 7 unique cell types. Endothelial cells were categorized into 8 subpopulations by hdWGCNA; notably, Endothelial Cells-2 exhibited significant interactions with fibroblasts mediated by PDGF, PROS, and GAS signaling pathways. Integration of hdWGCNA, scCODE and FindMarkers, 10 key genes were identified, which were subsequently refined to DBP, NR1D1, and TEF following PPI analysis. These genes demonstrated marked downregulation the progression of MI, as confirmed by subsequent in vivo experiments. This study highlights the crucial roles of DBP, NR1D1, and TEF in MI development, providing a basis for future research on endothelial cell function in cardiovascular disease.

Mitigating effects of hydroxysafflor yellow a on atherosclerotic inflammatory responses based on flavonoid macromolecule compound: Inhibition of Piezo1-YAP/JNK protein pathway

Atherosclerosis (AS) is an important cardiovascular disease caused by inflammation. The inhibitory effect of HysA on the Piezo1-YAP/JNK signaling pathway in a mouse model of AS was studied to clarify its anti-inflammatory effects. The study evaluated HysA's ability to bind Piezo1 through molecular docking analysis. C57BL/6 mice were used to establish AS model, and cell treatment and animal experiments were carried out. Inflammatory markers and lipid accumulation were evaluated using quantitative real-time PCR (qRT-PCR), Westernblot, enzyme-linked immunosorbent assay (ELISA), immunofluorescence, and oil red O staining techniques. Weight changes in mice were recorded to monitor disease progression. The molecular docking results show that HysA has a good binding affinity with Piezo1. In a mouse model of AS, treatment with HysA significantly reduced levels of inflammatory cytokines and inhibited the activation of YAP and JNK signaling pathways. The HysA treatment group showed lower oil red O staining levels, indicating that it effectively mitigated lipid deposition. Therefore, HysA significantly alleviates the inflammatory response of atherosclerosis by inhibiting the Piezo1-YAP/JNK signaling pathway, suggesting its potential application in the prevention and treatment of atherosclerosis.

Development and validation of a highly sensitive HPLC method for quantifying cardiovascular drugs in human plasma using dual detection

Cardiovascular diseases are the major cause of global mortality, and often require the concomitant use of a number of drugs to prevent and reduce these deaths. The challenge is to find effective and accurate methods for analyzing these drugs in plasma. This research introduces an innovative, sustainable HPLC-FLD method for the concurrent determination of bisoprolol (BIS), amlodipine besylate (AML), telmisartan (TEL), and atorvastatin (ATV) within human plasma. Chromatographic separation was achieved using an isocratic elution mode on a Thermo Hypersil BDS C18 column (150 × 4.6 mm, 5.0 μm), while the mobile phase comprised of ethanol and 0.03 M potassium phosphate buffer (pH 5.2) in a 40:60 ratio, with a flow rate of 0.6 mL/min. The eluate was analyzed using UV detection within the wavelength range of 210-260 nm to confirm effective separation of the four cardiovascular drugs. For enhanced specificity, a fluorescence detector was set to 227ex/298em for BIS, 294ex/365em for TEL, 274ex/378em for ATV, and 361ex/442em for amlodipine. The method was validated following the International Council for Harmonisation (ICH) guidelines. Linearity was established within the ranges of 5-100 ng/mL for BIS and AML, 0.1-5 ng/mL for TEL, and 10-200 ng/mL for ATV, ensuring accuracy and precision. The significant of the current work represented in introduction of a highly sensitive, and selective analytical method, utilizing an economical sample preparation strategy, for the simultaneous determination of four different cardiovascular drugs (bisoprolol, amlodipine, telmisartan, and atorvastatin) in spiked human plasma. The extraction of sample was carried by liquid-liquid extraction (LLE) and analyzed by LC-fluorescence detector. The chromatographic run was short (less than10 min) which is a greet economical value.

Targeting of AMPK/MTOR signaling in the management of atherosclerosis: Outmost leveraging

Atherosclerosis (AS) is a chronic vascular disorder that is characterized by the thickening and narrowing of arteries due to the development of atherosclerotic plaques. The traditional risk factors involved in AS are obesity, type 2 diabetes (T2D), dyslipidemia, hypertension, and smoking. Furthermore, non-traditional risk factors for AS, such as inflammation, sleep disturbances, physical inactivity, air pollution, and alterations of gut microbiota, gained attention in relation to the pathogenesis of AS. Interestingly, the pathogenesis of AS, is complex and related to different abnormalities of cellular and sub-cellular signaling pathways. It has been illustrated that AMP-activated protein kinase (AMPK) and mammalian target of rapamycin (MTOR) pathways are involved in AS pathogenesis. Mounting evidence indicated that AMPK plays a critical role in attenuating the development of AS by activating autophagy, which is impaired during atherogenesis. AMPK has a vasculoprotective effect by reducing lipid accumulation, inflammatory cell proliferation, and the release of pro-inflammatory cytokines, as well as decreasing inflammatory cell adhesion to the vascular endothelium. AMPK activation by metformin inhibits the migration of vascular smooth muscle cells (VSMCs) and AS development. However, the MTOR pathway contributes to AS by inhibiting autophagy, highlighting autophagy as a crucial link between the AMPK and MTOR pathways in AS pathogenesis. The MTOR is a key inducer of endothelial dysfunction and is involved in the development of AS. Therefore, both the AMPK and MTOR pathways play a crucial role in the pathogenesis of AS. However, the exact role of AMPK and MTOR pathways in the pathogenesis of AS is not fully clarified. Therefore, this review aims to discuss the potential role of the AMPK/MTOR signaling pathway in AS, and how AMPK activators and MTOR inhibitors influence the development and progression of AS. In conclusion, AMPK activators and MTOR inhibitors have vasculoprotective effects against the development and progression of AS.

Long-Term Systolic Blood Pressure Time in Target Range and Cardiovascular Disease in Individuals With Hypertension

BACKGROUND

Previous post hoc analyses of clinical trials have suggested that a higher percentage of systolic blood pressure time in target range (SBP-TTR) was associated with a decreased risk of cardiovascular disease (CVD). However, there is limited evidence from large prospective cohort studies on the relationship between long-term SBP-TTR and the risk of CVD.

OBJECTIVES

The purpose of this study was to assess the association between long-term SBP-TTR and the risk of CVD in adults with hypertension.

METHODS

This study included 26,929 hypertensive patients (mean age 52.8 ± 10.7 years; 83.1% males), free of CVD at baseline from the Kailuan Study. Blood pressure was measured biennially from 2006 to 2012, and the SBP target range was defined as 120 to 140 mm Hg. SBP-TTR was calculated by the Rosendaal linear interpolation method. Incident CVD events were ascertained via the linkage of electronic health record data.

RESULTS

During a median follow-up of 8.6 years, 2,565 CVD, including 472 myocardial infarction and 2,151 stroke cases were documented. Comparing the high SBP-TTR (75%-100%) with the low SBP-TTR (0%-25%) group, the multivariable HRs were 0.67 (95% CI: 0.59-0.76) for CVD, 0.76 (95% CI: 0.56-1.02) for myocardial infarction, and 0.64 (95% CI: 0.56-0.74) for stroke. In addition, the association between SBP-TTR and CVD risk was stronger among individuals aged <65 years than their older counterparts (P for interaction <0.001).

CONCLUSIONS

A greater percentage of SBP-TTR was associated with a lower risk of CVD among patients with hypertension. These findings underscore the importance of maintaining SBP within the target range for the prevention of CVD among hypertensive individuals.

Acacetin as a natural cardiovascular therapeutic: mechanisms and preclinical evidence

Globally, cardiovascular disease (CVD) has emerged as a leading cause of mortality and morbidity. As the world's population ages, CVD incidence is on the rise, and extensive attention has been drawn to optimizing the therapeutic regimens. Acacetin, a natural flavonoid derived from various plants, has been demonstrated to have a wide spectrum of pharmacological properties, such as antioxidant, anti-inflammatory, anti-bacterial, and anti-tumor activities, as well as protective effects on diverse tissues and organs. Recently, increasing numbers of studies (mostly preclinical) have indicated that acacetin has potential cardiovascular protective effects and might become a novel therapeutic strategy for CVDs. The importance of acacetin in CVD treatment necessitates a systematic and comprehensive review of its protective effects on the cardiovascular system and the underlying mechanisms involved. Here, we first provide an overview of some basic properties of acacetin. Subsequently, the protective effects of acacetin on multiple CVDs, like arrhythmias, cardiac ischemia/reperfusion injury, atherosclerosis, myocardial hypertrophy and fibrosis, drug-induced cardiotoxicity, diabetic cardiomyopathy, hypertension, and cardiac senescence, are discussed in detail. The underlying mechanisms by which acacetin exhibits cardiovascular protection appear to involve suppressing oxidative stress, reducing inflammation, preventing cardiomyocyte apoptosis and endothelial cell injury, as well as regulating mitochondrial autophagy and lipid metabolism. Meanwhile, several critical signaling pathways have also been found to mediate the protection of acacetin against CVDs, including phosphoinositide 3-kinase/protein kinase B/mechanistic target of rapamycin (PI3K/Akt/mTOR), sirtuin 1/AMP-activated protein kinase/peroxisome proliferator-activated receptor-γ coactivator-1α (Sirt1/AMPK/PGC-1α), transforming growth factor-β1/small mothers against decapentaplegic 3 (TGF-β1/Smad3), protein kinase B/endothelial nitric oxide synthase (Akt/eNOS), and others. Finally, we highlight the existing problems associated with acacetin that need to be addressed, such as the requirement for clinical evidence and enhanced bioavailability, as well as its potential as a promising cardiovascular drug candidate.

Association between the atherogenic index of plasma and the systemic immuno-inflammatory index using NHANES data from 2005 to 2018

The atherogenic index of plasma (AIP) is used to evaluate the risk of atherosclerosis, while the systemic immune-inflammation index (SII) measures inflammation. The AIP and SII are indicators used to predict diseases in various areas. This study aims to explore the relationship between AIP and SII. A cross-sectional study design was used to recruit 70,190 participants from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2018, excluding AIP missing data, SII missing data, participants under 20 years of age, and participants with missing covariates to eventually include 8163 participants. We used weighted multiple linear regression analysis, trend test, smooth curve fitting and threshold effect analysis to examine the relationship between AIP and SII. Among the 8163 participants included in the study, the mean (± SD) age was 48.412 ± 16.842 years. The mean SII (± SD) for all participants was 519.910 ± 316.974. In a model adjusted for all covariates (Model 3), AIP showed a significant positive correlation with SII [β (95% CI) 32.497 (5.425, 59.569), P = 0.021]. The smooth curve fitting results of AIP and SII are an "inverted U-shape" non-linear relationship, and the inflection point is at AIP = 0.82. This positive association between AIP and SII was found only in females and participants under 50. Specifically, for females, the positive correlation between AIP and SII was linear [β (95% CI) 80.791 (44.625, 116.958); P < 0.001]. In participants under 50, the positive correlation between AIP and SII was [β (95% CI) 34.198 (3.087, 65.310); P = 0.034], and there was also an "inverted U-shape" non-linear relationship with an inflection point of AIP = 0.549. For participants aged 20-50 years and males, the smooth curve showed a "down-flat-down" non-linear relationship. There is a significant positive correlation between AIP and SII. A positive association between AIP and SII was observed exclusively in females and among participants under 50. Furthermore, AIP and SII demonstrated a nonlinear relationship that resembles an "inverted U-shape". These findings offer new insights into the prevention, treatment, and management of cardiovascular disease. However, further comprehensive cohort studies are necessary to validate the relationship between AIP and SII.

Aerobic exercise modulates aortic chondrogenesis and calcification via 5-methoxytryptophan and P38MAPK in atherosclerotic rats

BACKGROUND

5-Methoxytryptophan (5-MTP), a new endothelial factor with vasoprotective and anti-inflammatory effects, reduces aortic chondrogenesis and calcification during atherosclerosis. The aim of this study was to investigate the effects of aerobic exercise on aortic chondrogenesis and calcification during atherosclerosis in rats. To investigate the effect of aerobic exercise on the expression of 5-MTP/P38 MAPK signaling pathway. To lay a theoretical foundation for the therapeutic effect of exercise in rat atherosclerosis model.

METHODS

Establishment of a rat model of atherosclerosis using a high-fat diet combined with intraperitoneal injection of vitamin D3 (VD3). The aerobic exercise group underwent moderate-intensity aerobic exercise on an exercise treadmill for 8 weeks, while the atherosclerosis model group and the control group did not exercise. After exercise, blood and aortic samples were collected from all rats to evaluate the levels of serum triglyceride (TG), cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDLC), aortic chondrogenesis, calcification, 5-MTP level, collagen II, P38MAPK, pp38 MAPK, and IL-6 protein content.

RESULTS

(1)8 weeks of aerobic exercise significantly reduced aortic chondrogenesis, area of calcification, serum LDL-C, TC levels, atherosclerotic index and serum IL-6 levels in rats (p < 0.01), and lowered TG levels (p < 0.05);(2)8 weeks of aerobic exercise significantly increased aortic 5-MTP levels (p < 0.01) and decreased the content of aortic pp38MAPK, collagen II and IL-6 proteins significantly (p < 0.01). The pp38MAPK/P38MAPK ratio was also decreased (p < 0.01).

CONCLUSION

8 weeks of aerobic exercise training improved dyslipidemia and reduced aortic chondrogenesis and calcification formation in AS rats. The mechanism may be related to increasing aortic 5-MTP levels and inhibiting the P38MAPK/ IL-6 signaling pathway.

Endothelial MICU1 protects against vascular inflammation and atherosclerosis by inhibiting mitochondrial calcium uptake

Mitochondrial dysfunction fuels vascular inflammation and atherosclerosis. Mitochondrial calcium uptake 1 (MICU1) maintains mitochondrial Ca2+ homeostasis. However, the role of MICU1 in vascular inflammation and atherosclerosis remains unknown. Here, we report that endothelial MICU1 prevents vascular inflammation and atherosclerosis by maintaining mitochondrial homeostasis. We observed that vascular inflammation was aggravated in endothelial cell-specific Micu1 knockout mice (Micu1ECKO) and attenuated in endothelial cell-specific Micu1 transgenic mice (Micu1ECTg). Furthermore, hypercholesterolemic Micu1ECKO mice also showed accelerated development of atherosclerosis, while Micu1ECTg mice were protected against atherosclerosis. Mechanistically, MICU1 depletion increased mitochondrial Ca2+ influx, thereby decreasing the expression of the mitochondrial deacetylase sirtuin 3 (SIRT3) and the ensuing deacetylation of superoxide dismutase 2 (SOD2), leading to the burst of mitochondrial reactive oxygen species (mROS). Of clinical relevance, we observed decreased MICU1 expression in the endothelial layer covering human atherosclerotic plaques and in human aortic endothelial cells exposed to serum from patients with coronary artery diseases (CAD). Two-sample Wald ratio Mendelian randomization further revealed that increased expression of MICU1 was associated with decreased risk of CAD and coronary artery bypass grafting (CABG). Our findings support MICU1 as an endogenous endothelial resilience factor that protects against vascular inflammation and atherosclerosis by maintaining mitochondrial Ca2+ homeostasis.

Regulatory effects of resveratrol on nitric oxide signaling in cardiovascular diseases

Cardiovascular illnesses are multifactorial disorders and represent the primary reasons for death worldwide, according to the World Health Organization. As a signaling molecule, nitric oxide (NO) is extremely permeable across cellular membranes owing to its unique molecular features, like its small molecular size, lipophilicity, and free radical properties. Some of the biological effects of NO are vasodilation, inhibition in the growth of vascular smooth muscle cells, and functional regulation of cardiac cells. Several therapeutic approaches have been tested to increase the production of NO or some downstream NO signaling pathways. The health benefits of red wine are typically attributed to the polyphenolic phytoalexin, resveratrol (3,5,4'-trihydroxy-trans-stilbene), which is found in several plant species. Resveratrol has beneficial cardiovascular properties, some of which are mediated through endothelial nitric oxide synthase production (eNOS). Resveratrol promotes NO generation from eNOS through various methods, including upregulation of eNOS expression, activation in the enzymatic activity of eNOS, and reversal of eNOS uncoupling. Additionally, by reducing of oxidative stress, resveratrol inhibits the formation of superoxide and inactivation NO, increasing NO bioavailability. This review discusses the scientific literature on resveratrol's beneficial impact on NO signaling and how this effect improves the function of vascular endothelium.

The role of long non-coding RNAs in cardiovascular diseases: A comprehensive review

Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality worldwide, posing significant challenges to healthcare systems. Despite advances in medical interventions, the molecular mechanisms underlying CVDs are not yet fully understood. For decades, protein-coding genes have been the focus of CVD research. However, recent advances in genomics have highlighted the importance of long non-coding RNAs (lncRNAs) in cardiovascular health and disease. Changes in lncRNA expression specific to tissues may result from various internal or external factors, leading to tissue damage, organ dysfunction, and disease. In this review, we provide a comprehensive discussion of the regulatory mechanisms underlying lncRNAs and their roles in the pathogenesis and progression of CVDs, such as coronary heart disease, atherosclerosis, heart failure, arrhythmias, cardiomyopathies, and diabetic cardiomyopathy, to explore their potential as therapeutic targets and diagnostic biomarkers.

Chromofungin mitigates free fatty acids-induced endothelial inflammation via inhibition of NOD-like receptor thermal protein domain-associated protein 3 mediated by adenosine 5'-monophosphate-activated protein kinase

Free fatty acids (FFAs) have emerged as significant risk factors for atherosclerosis (AS). Prolonged exposure to FFAs induces vascular endothelial injury, including inflammatory responses and oxidative stress, which are central events in AS. Chromofungin (CHR), a peptide derived from chromogranin A (CGA), has been implicated in various biological functions. However, its physiological roles in endothelial biology and its involvement in the pathological development of AS have not been previously reported. In the present study, we investigated the underlying mechanisms through which CHR exerts its beneficial effects on FFA-challenged human aortic endothelial cells (HAECs). We found that treatment with CHR ameliorated the FFA-induced reduction in cell viability and increase in lactate dehydrogenase (LDH) release. Additionally, CHR mitigated oxidative stress by reducing mitochondrial reactive oxygen species (ROS) levels and increasing superoxide dismutase (SOD) activity. Furthermore, exposure to FFAs increased NADPH oxidase (NOX) 4 expression at both the mRNA and protein levels, which were attenuated by CHR in a dose-dependent manner. Notably, CHR reduced the levels of nucleotide-binding domain and leucine-rich repeat-containing (NLR) family pyrin domain containing 3 (NLRP3), apoptosis-associated speck-like protein containing a CARD (ASC), and cleaved caspase-1 (p10), key components of the NLRP3 inflammasome complex, as well as interleukin 1β (IL-1β) and interleukin-18 (IL-18) expression. Mechanistically, it was demonstrated that FFAs reduced the phosphorylation of AMP-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC), which were rescued by CHR in a dose-dependent manner. Conversely, inhibition of AMPK with its specific inhibitor compound C abolished the protective effects of CHR against FFA-induced activation of the NLRP3 inflammasome in HAECs. Based on these findings, we conclude that CHR may serve as a promising agent for maintaining normal endothelial cell function and treating AS.

The Pivotal Role of Thiamine Supplementation in Counteracting Cardiometabolic Dysfunctions Associated with Thiamine Deficiency

The isolation, structural elucidation, and synthesis of pure thiamin were achieved in 1936, marking a milestone in vitamin research. As an organic compound soluble in water, thiamin is essential for carbohydrate metabolism in plants and animals, and in its active form-as part of the thiamin pyrophosphate coenzyme-performs these functions. Thereby, thiamin represents an essential vitamin to human health and is involved in several pathways that regulate several pathophysiological mechanisms. Cardiovascular disease is significantly impacted by thiamine imbalance and its supplementation offers substantial improvements to the associated conditions. In this comprehensive review, we aimed to examine the dual role of thiamine deficiency and accumulation, focusing on an analysis of the causes of thiamine deficiency. We detailed the effects of thiamine deficiency on metabolism and on cardiovascular risk and heart failure, explaining the molecular mechanisms involved in metabolic dysfunction, and highlighting the role of B1 vitamin supplementation in diabetes mellitus management and atherosclerosis development and progression. Indeed, B1 supplementation counteracts oxidative stress and inflammation, significantly ameliorating glycemic and lipemic profiles. Additionally, we reported the beneficial effects of thiamine in counteracting cardiotoxicity induced by cancer therapy. Although preclinical data strongly support the benefits of thiamine, clinical trial findings are in contrast and contradictory, hampered by limitations such as small sample sizes and inadequate follow-up. Further research is needed to investigate thiamine's potential benefits, overcoming current study limitations and evaluating its use as a supplemental therapy alongside standard treatments in different high-cardiovascular-risk conditions.

Cardiac Fibroblasts: Helping or Hurting

Cardiac fibroblasts (CFs) are the essential cell type for heart morphogenesis and homeostasis. In addition to maintaining the structural integrity of the heart tissue, muscle fibroblasts are involved in complex signaling cascades that regulate cardiomyocyte proliferation, migration, and maturation. While CFs serve as the primary source of extracellular matrix proteins (ECM), tissue repair, and paracrine signaling, they are also responsible for adverse pathological changes associated with cardiovascular disease. Following activation, fibroblasts produce excessive ECM components that ultimately lead to fibrosis and cardiac dysfunction. Decades of research have led to a much deeper understanding of the role of CFs in cardiogenesis. Recent studies using the single-cell genomic approach have focused on advancing the role of CFs in cellular interactions, and the mechanistic implications involved during cardiovascular development and disease. Arguably, the unique role of fibroblasts in development, tissue repair, and disease progression categorizes them into the friend or foe category. This brief review summarizes the current understanding of cardiac fibroblast biology and discusses the key findings in the context of development and pathophysiological conditions.

Methylseleninic Acid Elevating the Nrf2-GPX4 Axis Relieves Endothelial Dysfunction and Ferroptosis Induced by Arsenic Exposure

Chronic exposure to arsenic (As), a ubiquitous contaminant, poses deleterious health risks to humans, including cardiovascular disease. Recent studies have implicated ferroptosis, in which the essential micronutrient selenium (Se) plays a crucial role, in several As-induced pathological processes. However, whether Se can counteract As-induced endothelial dysfunction through ferroptosis remains unclear. Herein, methylseleninic acid (MSA), a methylselenium metabolite, was used as a Se supplement to investigate the underlying effect and mechanism of Se in As-induced endothelial dysfunction involving ferroptosis in vivo and in vitro. As exposure induced endothelial dysfunction in mice, as indicated by increased aortic permeability, increased number of circulating endothelial cells, and endothelial mitochondria exhibiting ferroptosis-related alterations. Additionally, As induced ferroptosis-related cell death in mouse aortic endothelial cells, accompanied by impaired redox homeostasis, relatively low Se status, and decreased expressions of selenoproteome, including GPX4. Notably, these were attenuated by MSA via activation of Nrf2 and upregulation of three GPX4 isoforms, which were further abrogated by the Nrf2 antagonist ML385. Finally, MSA exhibited ameliorative effects on endothelial ferroptosis and dysfunction in the aortas of As-exposed mice. These results demonstrate that As causes endothelial ferroptosis and dysfunction by affecting the Se-Nrf2/GPX4 axis, which can be relieved by MSA. This study provides novel evidence implicating Se in As-induced endothelial dysfunction by mitigating ferroptosis.

Treatment of endothelial cell dysfunction in atherosclerosis: a new perspective integrating traditional and modern approaches

Atherosclerosis (AS), a prime causative factor in cardiovascular disease, originates from endothelial cell dysfunction (ECD). Comprising a vital part of the vascular endothelium, endothelial cells play a crucial role in maintaining vascular homeostasis, optimizing redox balance, and regulating inflammatory responses. More evidence shows that ECD not only serves as an early harbinger of AS but also exhibits a strong association with disease progression. In recent years, the treatment strategies for ECD have been continuously evolving, encompassing interventions ranging from lifestyle modifications to traditional pharmacotherapy aimed at reducing risk factors, which also have demonstrated the ability to improve endothelial cell function. Additionally, novel strategies such as promising biotherapy and gene therapy have drawn attention. These methods have demonstrated enormous potential and promising prospects in improving endothelial function and reversing AS. However, it is essential to remain cognizant that the current treatments still present significant challenges regarding therapeutic efficacy, long-term safety, and ethical issues. This article aims to provide a systematic review of these treatment methods, analyze the mechanisms and efficacy of various therapeutic strategies, with the goal of offering insights and guidance for clinical practice, and further advancing the prevention and treatment of cardiovascular diseases.

Apelin-13 Inhibits the Adhesion of Monocytes to Endothelial Cells via the Gfi1/NF-κB Signaling Pathway

Oxidized low-density lipoprotein (ox-LDL)-induced endothelial dysregulation and the abnormal interaction between monocytes have been considered key risk factors for atherosclerosis. The study investigated the effects of apelin-13 on ox-LDL-induced endothelial dysfunction in human aortic endothelial cells (HAECs). Cells were stimulated with ox-LDL (100 mg/L), either alone or in combination with apelin-13 at concentrations of 3 and 6 µM. Multiple techniques, including real-time PCR, Western blot analysis, enzyme-linked immunosorbent assay (ELISA), cell attachment assays, and luciferase activity assays, were employed. Our results showed that ox-LDL reduced the expression of the G-protein-coupled apelin receptor (APJ) in HAECs. However, treatment with apelin-13 reduced the expression of lectin-like ox-LDL receptor 1 (LOX-1) against ox-LDL and inhibited the expression of pro-inflammatory cytokines in HAECs. Real-time PCR and ELISA assay demonstrated that apelin-13 also inhibited the expression of cell adhesion molecules intercellular cell adhesion molecule-1 (ICAM-1) and E-selectin. The calcein AM staining method displayed that apelin-13 mitigated ox-LDL-induced attachment of THP-1 monocytes to HAECs. Furthermore, apelin-13 prevented the reduction of growth factor independence-1 (Gfi1) and the activation of NF-κB in HAECs, as evidenced by the luciferase activity assay. Knockdown of Gfi1 counteracted the inhibitory effects of apelin-13 on the attachment of THP-1 monocytes to HAECs, suggesting that the protective effects of apelin-13 in endothelial dysfunction are mediated by the Gfi1/ NF-κB signaling pathway. These findings suggest that apelin-13 may have therapeutic potential in preventing atherosclerosis by improving endothelial function and reducing inflammation.

Protocol to generate a 3D atherogenesis-on-chip model for studying endothelial-macrophage crosstalk in atherogenesis

The endothelium is the gatekeeper of vessel health, and its dysfunction is pivotal in driving atherogenesis. Here, we present a protocol to replicate endothelial-macrophage crosstalk during atherogenesis, called the "atherogenesis-on-chip" model, based on the Emulate dual-channel perfusion system. We describe a model for studying endothelial-macrophage interactions during atherogenesis in human aortic endothelial cells and human macrophages using qPCR and secretome analysis, fluorescence microscopy, and flow cytometry. This protocol could be adapted toward more complex plaque microenvironment or other disease settings.

Impact of anti-inflammatory diets on cardiovascular disease risk factors: a systematic review and meta-analysis

Introduction

Chronic inflammation, via multiple pathways, influences blood pressure and lipid profiles, serving as a significant risk factor for the onset of cardiovascular disease (CVD). Anti-inflammatory dietary patterns may ameliorate CVD risk factors through the modulation of inflammatory mediators and metabolic factors, potentially leading to improved cardiovascular outcomes. Current findings regarding the relationship between dietary habits and CVD risk factors, such as blood pressure and lipid levels, exhibit considerable variability. We performed a comprehensive systematic review and meta-analysis to explore the possible association between anti-inflammatory dietary patterns (such as the Mediterranean diet, DASH diet, Nordic diet, Ketogenic diet, and Vegetarian diet) and CVD risk factors.

Methods

We conducted a comprehensive search across five databases: PubMed, Web of Science, Cochrane Library, Embase, and China National Knowledge Infrastructure (CNKI). Ultimately, we identified 18 eligible randomized controlled trials (including randomized crossover trials), which were subjected to meta-analysis utilizing RevMan 5 and Stata 18.

Results

A comprehensive meta-analysis of these studies conducted based on random effects model indicated that, in comparison to an Omnivorous diet, interventions centered on anti-inflammatory diets were linked to significant reductions in Systolic Blood Pressure (SBP) (MD: -3.99, 95% CI: -6.01 to -1.97; p = 0.0001), Diastolic Blood Pressure (DBP) (MD: -1.81, 95% CI: -2.73 to -0.88; p = 0.0001), Low Density Lipoprotein Cholesterol (LDL-C) (SMD: -0.23, 95% CI: -0.39 to -0.07; p = 0.004), Total Cholesterol (TC) (SMD: -0.31, 95% CI: -0.43 to -0.18; p < 0.00001) and High-sensitivity C-reactive Protein (hs-CRP) (SMD: -0.16, 95% CI: -0.31 to -0.00; p = 0.04). No notable correlations were identified between High Density Lipoprotein Cholesterol (HDL-C) and Triglycerides (TG).

Discussion

The findings indicate that anti-inflammatory diets may lower serum hs-CRP levels and positively influence the reduction of CVD risk factors, such as blood pressure and lipid profiles, thereby contributing to the prevention and progression of cardiovascular conditions. Most of the outcome indicators had low heterogeneity; sensitivity analyses were subsequently conducted on outcome measures demonstrating substantial heterogeneity, revealing that the findings remained consistent.

Insight into the Mechanistic role of Colchicine in Atherosclerosis

PURPOSE OF REVIEW

Globally, the prevalence of atherosclerosis (AS) is rising. Currently, there is no specific drug for AS. Therefore, this review aims to discuss the protective mechanisms of colchicine against the development and progression of atherosclerosis (AS).

RECENT FINDINGS

Many studies highlighted that the anti-inflammatory drug colchicine reduces the severity of AS, although the underlying mechanism for the beneficial effect of colchicine was not fully clarified. AS is a chronic progressive vascular disorder characterized by the formation of atherosclerotic plaques. Endothelial dysfunction is an initial stage in the pathogenesis of AS that is induced by oxidized low-density lipoprotein (oxLDL). Engulfment of oxLDL by macrophages triggers the development of inflammation due to the release of pro-inflammatory cytokines and growth factors. Inflammatory and adhesion molecules are involved in the pathogenesis of AS. Infiltration and accumulation of leukocytes provoke erosion, rupture, and thrombosis of the atherosclerotic plaque. Therefore, targeting inflammation and leukocyte infiltration by anti-inflammatory agents may reduce AS progression and complications. The anti-inflammatory drug colchicine reduces the severity of AS, although the underlying mechanism for the beneficial effect of colchicine was not fully elucidated.

IN CONCLUSION

colchicine through inhibition of vascular inflammation, oxidative stress, platelet aggregation and the modulation of autophagy reduces the development and progression of AS.

Cardiometabolic Risk in Psoriatic Arthritis: A Hidden Burden of Inflammation and Metabolic Dysregulation

Psoriatic arthritis (PsA) is a chronic inflammatory disease that extends beyond musculoskeletal and dermatologic involvement to elevate cardiometabolic risk. Emerging evidence highlights the critical role of systemic inflammation in metabolic dysregulation, accelerating insulin resistance, dyslipidemia, and oxidative stress, all of which contribute to the increased burden of cardiovascular disease in PsA. This review explores the intricate interplay between inflammatory mediators-such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-17 (IL-17),-adipokine imbalances, and lipid metabolism abnormalities, all of which foster endothelial dysfunction and atherosclerosis. The dysregulation of adipokines, including leptin, adiponectin, and resistin, further perpetuates inflammatory cascades, exacerbating cardiovascular risk. Additionally, the metabolic alterations seen in PsA, particularly insulin resistance and lipid dysfunction, not only contribute to cardiovascular comorbidities but also impact disease severity and therapeutic response. Understanding these mechanistic links is imperative for refining risk stratification strategies and tailoring interventions. By integrating targeted immunomodulatory therapies with metabolic and cardiovascular risk management, a more comprehensive approach to PsA treatment can be achieved. Future research must focus on elucidating shared inflammatory and metabolic pathways, enabling the development of innovative therapeutic strategies to mitigate both systemic inflammation and cardiometabolic complications in PsA.

NEK2 inhibition alleviates lipopolysaccharide-induced endothelial injury

The endothelial barrier regulates substance transfer across an extensive surface area, and vascular leakage may contribute to various inflammatory conditions, including acute respiratory distress syndrome and sepsis. NEK2 possesses a significant role in regulating cellular processes, and its overexpression has been linked to human disease. The present study investigates the effects of NEK2 inhibitor NCL 00017509 in endothelial barrier dysfunction and inflammation. Our results indicate that the aforementioned compound effectively suppresses lipopolysaccharide-induced activation of Cofilin and MLC2, which are crucial cytoskeletal components. NEK2 inhibition reduced endothelial paracellular permeability, reactive oxygen species generation, and phosphorylation of key inflammatory proteins (eg, ERK1/2, P38, STAT1, and STAT3) in cells exposed to lipopolysaccharide. Further investigation into the application of NEK2 inhibitors in preclinical models of direct and indirect lung injury will substantiate our findings.

Unraveling the metabolic‒epigenetic nexus: a new frontier in cardiovascular disease treatment

Cardiovascular diseases are the leading causes of death worldwide. However, there are still shortcomings in the currently employed treatment methods for these diseases. Therefore, exploring the molecular mechanisms underlying cardiovascular diseases is an important avenue for developing new treatment strategies. Previous studies have confirmed that metabolic and epigenetic alterations are often involved in cardiovascular diseases across patients. Moreover, metabolic and epigenetic factors interact with each other and affect the progression of cardiovascular diseases in a coordinated manner. Lactylation is a novel posttranslational modification (PTM) that links metabolism with epigenetics and affects disease progression. Therefore, analyzing the crosstalk between cellular metabolic and epigenetic factors in cardiovascular diseases is expected to provide insights for the development of new treatment strategies. The purpose of this review is to describe the relationship between metabolic and epigenetic factors in heart development and cardiovascular diseases such as heart failure, myocardial infarction, and atherosclerosis, with a focus on acylation and methylation, and to propose potential therapeutic measures.