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Pyrpyris N, Dimitriadis K, Beneki E, Iliakis P, Soulaidopoulos S, Tsioufis P, Adamopoulou E, Kasiakogias A, Sakalidis A, Koutsopoulos G, Aggeli K, Tsioufis K. LOX-1 Receptor: A Diagnostic Tool and Therapeutic Target in Atherogenesis. Curr Probl Cardiol 2024; 49:102117. [PMID: 37802161 DOI: 10.1016/j.cpcardiol.2023.102117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/08/2023]
Abstract
Low-density lipoprotein (LDL) and oxidized LDL (oxLDL) are major contributors to atherogenesis, as endogenous antigens, via several receptors such as LOX 1. A PubMed search was conducted in order to identify relevant articles regarding LOX-1's role in the atherosclerosis, diagnosis, prognostic use and molecules that could be used for therapy. The references of the manuscripts obtained were also reviewed, in order to find additional relevant bibliography. LOX-1 is a lectin-like pattern recognition receptor, mostly expressed in endothelial cells (ECs) which can bind a variety of molecules, including oxLDL and C-reactive protein (CRP). LOX-1 plays a key role in oxLDL's role as a causative agent of atherosclerosis through several pathologic mechanisms, such as oxLDL deposition in the subintima, foam cell formation and endothelial dysfunction. Additionally, LOX-1 acts a scavenger receptor for oxLDL in macrophages and can be responsible for oxLDL uptake, when stimulated. Serum LOX-1 (sLOX-1) has emerged as a new, potential biomarker for diagnosis of acute coronary syndromes, and it seems promising for use along with other common biomarkers in everyday clinical practice. In a therapeutic perspective, natural as well as synthetic molecules exert anti-LOX-1 properties and attain the receptor's pathophysiological effects, thus extensive research is ongoing to further evaluate molecules with therapeutic potential. However, most of these molecules need further trials in order to properly assess their safety and efficacy for clinical use. The aim of this review is to investigate LOX-1 role in atherogenesis and explore its potential as diagnostic tool and therapeutic target.
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Affiliation(s)
- Nikolaos Pyrpyris
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Kyriakos Dimitriadis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece.
| | - Eirini Beneki
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Panagiotis Iliakis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Stergios Soulaidopoulos
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Panagiotis Tsioufis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Elena Adamopoulou
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Alexandros Kasiakogias
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Athanasios Sakalidis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - George Koutsopoulos
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Konstantina Aggeli
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Konstantinos Tsioufis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
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Schiopu A, Björkbacka H, Narasimhan G, Loong BJ, Engström G, Melander O, Orho-Melander M, Nilsson J. Elevated soluble LOX-1 predicts risk of first-time myocardial infarction. Ann Med 2023; 55:2296552. [PMID: 38134912 PMCID: PMC10763917 DOI: 10.1080/07853890.2023.2296552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND There is an unmet clinical need for novel therapies addressing the residual risk in patients receiving guideline preventive therapy for coronary heart disease. Experimental studies have identified a pro-atherogenic role of the oxidized LDL receptor LOX-1. We investigated the association between circulating soluble LOX-1 (sLOX-1) and the risk for development of myocardial infarction. METHODS The study subjects (n = 4658) were part of the Malmö Diet and Cancer study. The baseline investigation was carried out 1991-1994 and the incidence of cardiovascular events monitored through national registers during a of 19.5 ± 4.9 years follow-up. sLOX-1 and other biomarkers were analyzed by proximity extension assay and ELISA in baseline plasma. RESULTS Subjects in the highest tertile of sLOX-1 had an increased risk of myocardial infarction (hazard ratio (95% CI) 1.76 (1.40-2.21) as compared with those in the lowest tertile. The presence of cardiovascular risk factors was related to elevated sLOX-1, but the association between sLOX-1 and risk of myocardial infarction remained significant when adjusting for risk factors. CONCLUSIONS In this prospective population study we found an association between elevated sLOX-1, the presence of carotid disease and the risk for first-time myocardial infarction. Taken together with previous experimental findings of a pro-atherogenic role of LOX-1, this observation supports LOX-1 inhibition as a possible target for prevention of myocardial infarction.
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Affiliation(s)
- Alexandru Schiopu
- Department of Clinical Sciences Malmö, Lund University, Sweden
- Department of Transitional Science, Lund University, Sweden
| | | | | | - Bi Juin Loong
- Department of Clinical Sciences Malmö, Lund University, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences Malmö, Lund University, Sweden
| | - Olle Melander
- Department of Clinical Sciences Malmö, Lund University, Sweden
| | | | - Jan Nilsson
- Department of Clinical Sciences Malmö, Lund University, Sweden
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Narsini R, Bhaskar V, Luqman H, O SS, Parupati SSR, B V RRA, Krishna Mohan I. Clinical Utility of Soluble Lectin Type Oxidized Low-Density Lipoprotein Receptor as a Biomarker for Myocardial Infarction and Stable Angina. Cureus 2023; 15:e50719. [PMID: 38234947 PMCID: PMC10792998 DOI: 10.7759/cureus.50719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 01/19/2024] Open
Abstract
Background and objectives Endothelial soluble lectin-type oxidized low-density lipoprotein receptor 1 (sLOX-1) recognizes oxidized low-density lipoprotein (LDL) and triggers downstream signaling leading to atherosclerosis. The objective of this study was to demonstrate the utility of sLOX-1 as a biomarker for detecting acute myocardial infarction (MI) and stable angina (SA) and to develop a diagnostic algorithm for distinguishing coronary vasospasm from coronary plaque rupture. Methods We enrolled 62 patients who underwent diagnostic coronary angiography (CAG) and 30 healthy controls (21 men and nine women) and measured sLOX-1, troponin I, and cardiac myosin-binding protein C (c-MyBPC) using commercial kits. Results Patients with MI exhibited higher sLOX-1 levels (301.55 ± 196.16 pg/ml) than patients with stable angina (220.76 ± 103.65 pg/ml) and healthy controls (121.14 ± 77.10, F: 10.55, p<0.001). Although higher troponin I levels were detected in MI patients (263.00 ± 493.00 vs. 3.19 ± 2.15 ng/ml, p=0.0019), no significant elevation was observed in SA patients (1.91 ± 0.79 ng/ml). Plasma sLOX-1 levels showed a positive association with age (r=0.37, p=0.003), but not with gender (r=0.04, p=0.75). Troponin I showed no association with age (r=0.12, p=0.36) or gender (r=0.06, p=0.62). Receiver operating characteristic (ROC) curves revealed that among the three biomarkers, troponin-I showed a higher area under the curve (AUC) (AUC: 0.941), followed by sLOX-1 (AUC: 0.888), while c-MyBPC showed no clinical utility in the detection of MI (AUC: 0.666). Conclusions A marked elevation of sLOX-1 can detect MI and differentiate the presence or absence of plaque rupture, along with diagnosing stable angina.
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Affiliation(s)
| | - Vijaya Bhaskar
- Biochemistry, Nizam's Institute of Medical Sciences, Hyderabad, IND
| | - Hajra Luqman
- Biochemistry, Nizam's Institute of Medical Sciences, Hyderabad, IND
| | - Sai Satish O
- Cardiology, Nizam's Institute of Medical Sciences, Hyderabad, IND
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Florida EM, Li H, Hong CG, Ongstad EL, Gaddipati R, Sitaula S, Varma V, Parel PM, O'Hagan R, Chen MY, Teague HL, Playford MP, Karathanasis SK, Collén A, Mehta NN, Remaley AT, Sorokin AV. Relationship of Soluble Lectin-Like Low-Density Lipoprotein Receptor-1 (sLOX-1) With Inflammation and Coronary Plaque Progression in Psoriasis. J Am Heart Assoc 2023; 12:e031227. [PMID: 37982276 PMCID: PMC10727277 DOI: 10.1161/jaha.123.031227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/24/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Psoriasis is a chronic inflammatory condition associated with coronary artery disease risk. Uptake of oxidized low-density lipoprotein by the lectin-like low-density lipoprotein receptor-1 triggers release of the soluble extracellular domain of the receptor (sLOX-1). We sought to characterize the relationship between sLOX-1, inflammation, and coronary plaque progression in psoriasis. METHODS AND RESULTS A total of 327 patients with psoriasis had serum sLOX-1 levels measured at baseline by an ELISA-based assay. Stratification by high-sensitivity C-reactive protein ≥4.0 mg/L (quartile 4), identified 81 participants who had coronary plaque phenotyping at baseline and were followed longitudinally by coronary computed tomography angiography. Subjects within high-sensitivity C-reactive protein quartile 4 were middle-aged (51.47±12.62 years), predominantly men (54.3%) with moderate psoriasis disease severity (6.60 [interquartile range, 3.30-13.40]). In the study cohort, participants with sLOX-1 above the median displayed increased vulnerable coronary plaque features. At baseline, sLOX-1 was associated with total burden (rho=0.296; P=0.01), noncalcified burden (rho=0.286; P=0.02), fibro-fatty burden (rho=0.346; P=0.004), and necrotic burden (rho=0.394; P=0.002). A strong relationship between sLOX-1, noncalcified burden (β=0.19; P=0.03), and fibro-fatty burden (β=0.29; P=0.003) was found in fully adjusted models at baseline and 1- and 4-year follow-up. Finally, coronary plaque features progressed over 1 year regardless of biologic or systemic treatment in subjects with high sLOX-1. CONCLUSIONS Patients with psoriasis with both high sLOX-1 and high-sensitivity C-reactive protein levels have increased coronary plaque burden associated with atherosclerotic plaque progression independent of biologic and systemic treatment. Thus, sLOX-1 might be considered as a promising marker in coronary artery disease risk estimation beyond traditional risk factors. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT01778569.
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Affiliation(s)
- Elizabeth M. Florida
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Haiou Li
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Christin G. Hong
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Emily L. Ongstad
- Bioscience Cardiovascular, Research and Early Development, Cardiovascular, Renal, and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Ranjitha Gaddipati
- Bioscience Cardiovascular, Research and Early Development, Cardiovascular, Renal, and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Sadichha Sitaula
- Bioscience Cardiovascular, Research and Early Development, Cardiovascular, Renal, and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Vijayalakshmi Varma
- Translational Science and Experimental Medicine, Research and Early Development, Cardiovascular, Renal, and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Philip M. Parel
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Ross O'Hagan
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Marcus Y. Chen
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Heather L. Teague
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Martin P. Playford
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Sotirios K. Karathanasis
- NeoProgenBaltimoreMDUSA
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, National HeartLung and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Anna Collén
- Projects, Research and Early Development, Cardiovascular, Renal, and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Nehal N. Mehta
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Alan T. Remaley
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, National HeartLung and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Alexander V. Sorokin
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
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Sorokin AV, Hong CG, Aponte AM, Florida EM, Tang J, Patel N, Baranova IN, Li H, Parel PM, Chen V, Wilson SR, Ongstad EL, Collén A, Playford MP, Eggerman TL, Chen MY, Kotani K, Bocharov AV, Remaley AT. Association of oxidized ApoB and oxidized ApoA-I with high-risk coronary plaque features in cardiovascular disease. JCI Insight 2023; 8:e172893. [PMID: 37698922 PMCID: PMC10619497 DOI: 10.1172/jci.insight.172893] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/05/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Oxidized apolipoprotein B (oxLDL) and oxidized ApoA-I (oxHDL) are proatherogenic. Their prognostic value for assessing high-risk plaques by coronary computed tomography angiography (CCTA) is missing. METHODS In a prospective, observational study, 306 participants with cardiovascular disease (CVD) had extensive lipoprotein profiling. Proteomics analysis was performed on isolated oxHDL, and atherosclerotic plaque assessment was accomplished by quantitative CCTA. RESULTS Patients were predominantly White, overweight men (58.5%) on statin therapy (43.5%). Increase in LDL-C, ApoB, small dense LDL-C (P < 0.001 for all), triglycerides (P = 0.03), and lower HDL function were observed in the high oxLDL group. High oxLDL associated with necrotic burden (NB; β = 0.20; P < 0.0001) and fibrofatty burden (FFB; β = 0.15; P = 0.001) after multivariate adjustment. Low oxHDL had a significant reverse association with these plaque characteristics. Plasma oxHDL levels better predicted NB and FFB after adjustment (OR, 2.22; 95% CI, 1.27-3.88, and OR, 2.80; 95% CI, 1.71-4.58) compared with oxLDL and HDL-C. Interestingly, oxHDL associated with fibrous burden (FB) change over 3.3 years (β = 0.535; P = 0.033) when compared with oxLDL. Combined Met136 mono-oxidation and Trp132 dioxidation of HDL showed evident association with coronary artery calcium score (r = 0.786; P < 0.001) and FB (r = 0.539; P = 0.012) in high oxHDL, whereas Met136 mono-oxidation significantly associated with vulnerable plaque in low oxHDL. CONCLUSION Our findings suggest that the investigated oxidized lipids are associated with high-risk coronary plaque features and progression over time in patients with CVD. TRIAL REGISTRATION CLINICALTRIALS gov NCT01621594. FUNDING National Heart, Lung, and Blood Institute at the NIH Intramural Research Program.
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Affiliation(s)
| | - Christin G. Hong
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch
| | | | | | - Jingrong Tang
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland, USA
| | - Nidhi Patel
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch
| | - Irina N. Baranova
- Department of Laboratory Medicine, Clinical Center, NIH, Bethesda, Maryland, USA
| | - Haiou Li
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch
| | - Philip M. Parel
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch
| | - Vicky Chen
- Bioinformatics/Integrated Data Sciences Section, Research Technology Branch, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | - Sierra R. Wilson
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland, USA
| | | | - Anna Collén
- Projects, Research and Early Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Martin P. Playford
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch
| | - Thomas L. Eggerman
- Department of Laboratory Medicine, Clinical Center, NIH, Bethesda, Maryland, USA
| | - Marcus Y. Chen
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch
| | - Kazuhiko Kotani
- Division of Community and Family Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | | | - Alan T. Remaley
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland, USA
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Puig N, Solé A, Aguilera-Simon A, Griñán R, Rotllan N, Camps-Renom P, Benitez S. Novel Therapeutic Approaches to Prevent Atherothrombotic Ischemic Stroke in Patients with Carotid Atherosclerosis. Int J Mol Sci 2023; 24:14325. [PMID: 37762627 PMCID: PMC10531661 DOI: 10.3390/ijms241814325] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/18/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
Atherothrombotic stroke represents approximately 20% of all ischemic strokes. It is caused by large-artery atherosclerosis, mostly in the internal carotid artery, and it is associated with a high risk of early recurrence. After an ischemic stroke, tissue plasminogen activator is used in clinical practice, although it is not possible in all patients. In severe clinical situations, such as high carotid stenosis (≥70%), revascularization by carotid endarterectomy or by stent placement is carried out to avoid recurrences. In stroke prevention, the pharmacological recommendations are based on antithrombotic, lipid-lowering, and antihypertensive therapy. Inflammation is a promising target in stroke prevention, particularly in ischemic strokes associated with atherosclerosis. However, the use of anti-inflammatory strategies has been scarcely studied. No clinical trials are clearly successful and most preclinical studies are focused on protection after a stroke. The present review describes novel therapies addressed to counteract inflammation in the prevention of the first-ever or recurrent stroke. The putative clinical use of broad-spectrum and specific anti-inflammatory drugs, such as monoclonal antibodies and microRNAs (miRNAs) as regulators of atherosclerosis, will be outlined. Further studies are necessary to ascertain which patients may benefit from anti-inflammatory agents and how.
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Affiliation(s)
- Núria Puig
- Cardiovascular Biochemistry, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain; (N.P.); (A.S.)
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Building M, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, 08193 Barcelona, Spain; (A.A.-S.); (R.G.)
| | - Arnau Solé
- Cardiovascular Biochemistry, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain; (N.P.); (A.S.)
| | - Ana Aguilera-Simon
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Building M, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, 08193 Barcelona, Spain; (A.A.-S.); (R.G.)
- Stroke Unit, Department of Neurology, Hospital de La Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
| | - Raquel Griñán
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Building M, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, 08193 Barcelona, Spain; (A.A.-S.); (R.G.)
- Pathofisiology of Lipid-Related Deseases, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain;
| | - Noemi Rotllan
- Pathofisiology of Lipid-Related Deseases, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain;
- CIBER of Diabetes and Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Pol Camps-Renom
- Stroke Unit, Department of Neurology, Hospital de La Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
| | - Sonia Benitez
- Cardiovascular Biochemistry, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain; (N.P.); (A.S.)
- CIBER of Diabetes and Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Kott KA, Genetzakis E, Gray MP, Hansen P, McGuire HM, Yang JY, Grieve SM, Vernon ST, Figtree GA. Serum Soluble Lectin-like Oxidized Low-Density Lipoprotein Receptor-1 (sLOX-1) Is Associated with Atherosclerosis Severity in Coronary Artery Disease. Biomolecules 2023; 13:1187. [PMID: 37627252 PMCID: PMC10452248 DOI: 10.3390/biom13081187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
Risk-factor-based scoring systems for atherosclerotic coronary artery disease (CAD) remain concerningly inaccurate at the level of the individual and would benefit from the addition of biomarkers that correlate with atherosclerosis burden directly. We hypothesized that serum soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) would be independently associated with CAD and investigated this in the BioHEART study using 968 participants with CT coronary angiograms, which were scored for disease burden in the form of coronary artery calcium scores (CACS), Gensini scores, and a semi-quantitative soft-plaque score (SPS). Serum sLOX-1 was assessed by ELISA and was incorporated into regression models for disease severity and incidence. We demonstrate that sLOX-1 is associated with an improvement in the prediction of CAD severity when scored by Gensini or SPS, but not CACS. sLOX-1 also significantly improved the prediction of the incidence of obstructive CAD, defined as stenosis in any vessel >75%. The predictive value of sLOX-1 was significantly greater in the subgroup of patients who did not have any of the standard modifiable cardiovascular risk factors (SMuRFs). sLOX-1 is associated with CAD severity and is the first biomarker shown to have utility for risk prediction in the SMuRFless population.
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Affiliation(s)
- Katharine A. Kott
- Cardiovascular Discovery Group, Kolling Institute of Medical Research, University of Sydney, St Leonards, NSW 2065, Australia; (K.A.K.)
- Department of Cardiology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Elijah Genetzakis
- Cardiovascular Discovery Group, Kolling Institute of Medical Research, University of Sydney, St Leonards, NSW 2065, Australia; (K.A.K.)
| | - Michael P. Gray
- Cardiovascular Discovery Group, Kolling Institute of Medical Research, University of Sydney, St Leonards, NSW 2065, Australia; (K.A.K.)
- Department of Cardiology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Peter Hansen
- Department of Cardiology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Helen M. McGuire
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
- Ramaciotti Facility for Human Systems Biology, University of Sydney, Camperdown, NSW 2006, Australia
| | - Jean Y. Yang
- School of Mathematics and Statistics, University of Sydney, Camperdown, NSW 2006, Australia
| | - Stuart M. Grieve
- Imaging and Phenotyping Laboratory, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
- Department of Radiology, Royal Prince Alfred Hospital, Camperdown, NSW 2006, Australia
| | - Stephen T. Vernon
- Cardiovascular Discovery Group, Kolling Institute of Medical Research, University of Sydney, St Leonards, NSW 2065, Australia; (K.A.K.)
- Department of Cardiology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Gemma A. Figtree
- Cardiovascular Discovery Group, Kolling Institute of Medical Research, University of Sydney, St Leonards, NSW 2065, Australia; (K.A.K.)
- Department of Cardiology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
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8
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Hofmann A, Khorzom Y, Klimova A, Wolk S, Busch A, Sabarstinski P, Müglich M, Egorov D, Kopaliani I, Poitz DM, Kapalla M, Hamann B, Frank F, Jänichen C, Brunssen C, Morawietz H, Reeps C. Associations of Tissue and Soluble LOX-1 with Human Abdominal Aortic Aneurysm. J Am Heart Assoc 2023:e027537. [PMID: 37421287 PMCID: PMC10382096 DOI: 10.1161/jaha.122.027537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 05/04/2023] [Indexed: 07/10/2023]
Abstract
Background Indication for prophylactic surgical abdominal aortic aneurysm (AAA) repair depends on the maximal aortic diameter. The lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) is the major receptor for uptake of oxidized low-density lipoprotein cholesterol and is implicated in atherosclerosis. A soluble form of LOX-1 (sLOX-1) has been discussed as a novel biomarker in coronary artery disease and stroke. Herein, we assessed the regulation of aortic LOX-1 as well as the diagnostic and risk stratification potential of sLOX-1 in patients with AAA. Methods and Results Serum sLOX-1 was assessed in a case-control study in AAA (n=104) and peripheral artery disease (n=104). sLOX-1 was not statistically different between AAA and peripheral artery disease but was higher in AAA (β=1.28, P=0.04) after adjusting for age, atherosclerosis, type 2 diabetes, prescription of statins, β-blockers, ACE inhibitors, and therapeutic anticoagulation. sLOX-1 was not associated with the aortic diameter, AAA volume, or the thickness of the intraluminal thrombus. Aortic LOX-1 mRNA expression tended to be higher in AAA when compared with disease, and expression was positively associated with cleaved caspase-3, smooth muscle actin, collagen, and macrophage content. Conclusions In AAA, sLOX-1 was differently affected by age, cardiometabolic diseases, and corresponding medical therapies. Comparison with nonatherosclerotic disease would be beneficial to further elucidate the diagnostic potential of sLOX-1, although it was not useful for risk stratification. Aneurysmal LOX-1 mRNA expression was increased and positively associated with smooth muscle cells and collagen content, suggesting that LOX-1 is eventually not deleterious in human AAA and could counteract AAA rupture.
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Affiliation(s)
- Anja Hofmann
- Division of Vascular and Endovascular Surgery, Department of Visceral, Thoracic and Vascular Surgery Faculty of Medicine andUniversity Hospital Carl Gustav Carus, Technische Universität Dresden Dresden Germany
| | - Yazan Khorzom
- Division of Vascular and Endovascular Surgery, Department of Visceral, Thoracic and Vascular Surgery Faculty of Medicine andUniversity Hospital Carl Gustav Carus, Technische Universität Dresden Dresden Germany
| | - Anna Klimova
- National Center for Tumor Diseases, Partner Site Dresden and Institute for Medical Informatics and Biometry, Faculty of Medicine Technische Universität Dresden Dresden Germany
| | - Steffen Wolk
- Division of Vascular and Endovascular Surgery, Department of Visceral, Thoracic and Vascular Surgery Faculty of Medicine andUniversity Hospital Carl Gustav Carus, Technische Universität Dresden Dresden Germany
| | - Albert Busch
- Division of Vascular and Endovascular Surgery, Department of Visceral, Thoracic and Vascular Surgery Faculty of Medicine andUniversity Hospital Carl Gustav Carus, Technische Universität Dresden Dresden Germany
| | - Pamela Sabarstinski
- Division of Vascular and Endovascular Surgery, Department of Visceral, Thoracic and Vascular Surgery Faculty of Medicine andUniversity Hospital Carl Gustav Carus, Technische Universität Dresden Dresden Germany
| | - Margarete Müglich
- Division of Vascular and Endovascular Surgery, Department of Visceral, Thoracic and Vascular Surgery Faculty of Medicine andUniversity Hospital Carl Gustav Carus, Technische Universität Dresden Dresden Germany
| | - Dmitry Egorov
- Department of Physiology, Medical Faculty Carl Gustav Carus Technische Universität Dresden Germany
| | - Irakli Kopaliani
- Department of Physiology, Medical Faculty Carl Gustav Carus Technische Universität Dresden Germany
| | - David M Poitz
- Institute of Clinical Chemistry and Laboratory Medicine Medical Faculty Carl Gustav Carus, Technische Universität Dresden Dresden Germany
| | - Marvin Kapalla
- Division of Vascular and Endovascular Surgery, Department of Visceral, Thoracic and Vascular Surgery Faculty of Medicine andUniversity Hospital Carl Gustav Carus, Technische Universität Dresden Dresden Germany
| | - Bianca Hamann
- Division of Vascular and Endovascular Surgery, Department of Visceral, Thoracic and Vascular Surgery Faculty of Medicine andUniversity Hospital Carl Gustav Carus, Technische Universität Dresden Dresden Germany
| | - Frieda Frank
- Division of Vascular and Endovascular Surgery, Department of Visceral, Thoracic and Vascular Surgery Faculty of Medicine andUniversity Hospital Carl Gustav Carus, Technische Universität Dresden Dresden Germany
| | - Christian Jänichen
- Division of Vascular and Endovascular Surgery, Department of Visceral, Thoracic and Vascular Surgery Faculty of Medicine andUniversity Hospital Carl Gustav Carus, Technische Universität Dresden Dresden Germany
| | - Coy Brunssen
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden Dresden Germany
| | - Henning Morawietz
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden Dresden Germany
| | - Christian Reeps
- Division of Vascular and Endovascular Surgery, Department of Visceral, Thoracic and Vascular Surgery Faculty of Medicine andUniversity Hospital Carl Gustav Carus, Technische Universität Dresden Dresden Germany
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9
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Takasu S, Matsumoto S, Kanto Y, Shimmura S, Iwadate K, Iwadate K. Postmortem pericardial fluid sLOX-1 levels and LOX-1 immunostaining in forensic specimens: Relation to cause of death. Forensic Sci Int 2023; 347:111686. [PMID: 37062140 DOI: 10.1016/j.forsciint.2023.111686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/07/2023] [Accepted: 04/11/2023] [Indexed: 04/18/2023]
Abstract
Lectin-like oxidized LDL receptor-1 (LOX-1) is the endothelial receptor for oxidized LDL. This receptor's extracellular domain is released into the blood as soluble LOX-1 (sLOX-1) and has been linked to ischemic heart disease (IHD), cerebrovascular diseases (CVDs), obesity, and diabetes. We recently reported that sLOX-1 fluid levels in postmortem pericardial fluid were comparable to clinical values in live patients and that significant increases in sLOX-1 were observed in patients with IHD. However, postmortem serum and urine sLOX-1 levels were higher than serum levels in living patients. Here, we conducted LOX-1 immunostaining in forensic specimens (aorta and heart) and evaluated pericardial fluid sLOX-1 in 221 medicolegal autopsy cases (67 IHD, 11 CVD, 17 inflammatory diseases, and 126 control cases) with a postmortem interval < 72 h to assess the diagnostic efficiency of postmortem pericardial fluid sLOX-1. Furthermore, we evaluated the relationships between pericardial fluid sLOX-1 and body mass index (BMI), blood HbA1c, serum C-reactive protein (CRP), high-density lipoprotein cholesterol (HDL-C), and low-density-lipoprotein cholesterol (LDL-C). LOX-1 immunostaining positivity was found in the aortic intima. Pericardial fluid sLOX-1 levels were considerably higher in patients with IHD and CVD. However, there were no significant differences in patients with inflammatory diseases and controls. No associations between pericardial fluid sLOX-1 and BMI, HbA1c, CRP, HDL-C, or LDL-C were found. These results indicate sLOX-1 utility in the postmortem diagnosis of IHD and CVD.
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Affiliation(s)
- Shojiro Takasu
- Department of Forensic Medicine, Jikei University School of Medicine: Tokyo Jikeikai Ika Daigaku, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan.
| | - Sari Matsumoto
- Department of Forensic Medicine, Jikei University School of Medicine: Tokyo Jikeikai Ika Daigaku, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Yuko Kanto
- Department of Forensic Medicine, Jikei University School of Medicine: Tokyo Jikeikai Ika Daigaku, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Suzuka Shimmura
- Department of Forensic Medicine, Jikei University School of Medicine: Tokyo Jikeikai Ika Daigaku, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Kyoko Iwadate
- Department of Forensic Medicine, Jikei University School of Medicine: Tokyo Jikeikai Ika Daigaku, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Kimiharu Iwadate
- Department of Forensic Medicine, Jikei University School of Medicine: Tokyo Jikeikai Ika Daigaku, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
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10
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Vavere AL, Sinsakul M, Ongstad EL, Yang Y, Varma V, Jones C, Goodman J, Dubois VFS, Quartino AL, Karathanasis SK, Abuhatzira L, Collén A, Antoniades C, Koren MJ, Gupta R, George RT. Lectin-Like Oxidized Low-Density Lipoprotein Receptor 1 Inhibition in Type 2 Diabetes: Phase 1 Results. J Am Heart Assoc 2023; 12:e027540. [PMID: 36688371 PMCID: PMC9973634 DOI: 10.1161/jaha.122.027540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/12/2022] [Indexed: 01/24/2023]
Abstract
Background Blockade of the lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) is a potentially attractive mechanism for lowering inflammatory and lipid risk in patients with atherosclerosis. This study aims to assess the safety, tolerability, and target engagement of MEDI6570, a high-affinity monoclonal blocking antibody to LOX-1. Methods and Results This phase 1, first-in-human, placebo-controlled study (NCT03654313) randomized 88 patients with type 2 diabetes to receive single ascending doses (10, 30, 90, 250, or 500 mg) or multiple ascending doses (90, 150, or 250 mg once monthly for 3 months) of MEDI6570 or placebo. Primary end point was safety; secondary and exploratory end points included pharmacokinetics, immunogenicity, free soluble LOX-1 levels, and change in coronary plaque volume. Mean age was 57.6/58.1 years in the single ascending doses/multiple ascending doses groups, 31.3%/62.5% were female, and mean type 2 diabetes duration was 9.7/8.7 years. Incidence of adverse events was similar among cohorts. MEDI6570 exhibited nonlinear pharmacokinetics, with terminal half-life increasing from 4.6 days (30 mg) to 11.2 days (500 mg), consistent with target-mediated drug disposition. Dose-dependent reductions in mean soluble LOX-1 levels from baseline were observed (>66% at 4 weeks and 71.61-82.96% at 10 weeks in the single ascending doses and multiple ascending doses groups, respectively). After 3 doses, MEDI6570 was associated with nonsignificant regression of noncalcified plaque volume versus placebo (-13.45 mm3 versus -8.25 mm3). Conclusions MEDI6570 was well tolerated and demonstrated dose-dependent soluble LOX-1 suppression and a pharmacokinetic profile consistent with once-monthly dosing. Registration URL: https://clinicaltrials.gov/; Unique identifier: NCT03654313.
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Affiliation(s)
- Andrea L. Vavere
- Early Clinical Development, Research and Early Development, Cardiovascular, Renal and MetabolismBioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Marvin Sinsakul
- Early Clinical Development, Research and Early Development, Cardiovascular, Renal and MetabolismBioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Emily L. Ongstad
- Bioscience Cardiovascular, Research and Early Development, Cardiovascular, Renal and MetabolismBioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Ye Yang
- Early CVRM Biometrics, Research and Early Development, Cardiovascular, Renal and MetabolismBioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Vijayalakshmi Varma
- Early Clinical Development, Research and Early Development, Cardiovascular, Renal and MetabolismBioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Christopher Jones
- Clinical Pharmacology & Quantitative PharmacologyClinical Pharmacology & Safety Sciences, R&D, AstraZenecaGothenburgSweden
| | - Joanne Goodman
- Clinical Pharmacology & Quantitative PharmacologyClinical Pharmacology & Safety Sciences, R&D, AstraZenecaGothenburgSweden
| | - Vincent F. S. Dubois
- Clinical Pharmacology & Quantitative PharmacologyClinical Pharmacology & Safety Sciences, R&D, AstraZenecaGothenburgSweden
| | - Angelica L. Quartino
- Clinical Pharmacology & Quantitative PharmacologyClinical Pharmacology & Safety Sciences, R&D, AstraZenecaGothenburgSweden
| | - Sotirios K. Karathanasis
- Bioscience Cardiovascular, Research and Early Development, Cardiovascular, Renal and MetabolismBioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Liron Abuhatzira
- Early Clinical Development, Research and Early Development, Cardiovascular, Renal and MetabolismBioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Anna Collén
- Projects, Research and Early Development, Cardiovascular, Renal and MetabolismBioPharmaceuticals R&D, AstraZenecaGothenburgSweden
| | - Charalambos Antoniades
- Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordUnited Kingdom
| | - Michael J. Koren
- Jacksonville Center for Clinical Research (JCCR)JacksonvilleFLUSA
| | - Ruchi Gupta
- Bioscience Cardiovascular, Research and Early Development, Cardiovascular, Renal and MetabolismBioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Richard T. George
- Early Clinical Development, Research and Early Development, Cardiovascular, Renal and MetabolismBioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
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11
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Huo XL, Shao JH, Wang LS, Zhou CH, Ying XW, Jin XC. Correlation between LOX-1 and CX3CR1 and Vascular Endothelial Function, Fibrinolytic Activity, and Recurrence after Thrombolysis in Patients with Cerebral Infarction. NEUROCHEM J+ 2022. [DOI: 10.1134/s1819712422040109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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12
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Kraler S, Wenzl FA, Georgiopoulos G, Obeid S, Liberale L, von Eckardstein A, Muller O, Mach F, Räber L, Losdat S, Schmiady MO, Stellos K, Stamatelopoulos K, Camici GG, Srdic A, Paneni F, Akhmedov A, Lüscher TF. Soluble lectin-like oxidized low-density lipoprotein receptor-1 predicts premature death in acute coronary syndromes. Eur Heart J 2022; 43:1849-1860. [PMID: 35567560 DOI: 10.1093/eurheartj/ehac143] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/10/2022] [Accepted: 03/07/2022] [Indexed: 08/27/2023] Open
Abstract
AIMS The lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) and its shedding product [soluble LOX-1 (sLOX-1)] are implicated in atherosclerotic cardiovascular disease (ASCVD) pathogenesis. Herein, we examined the relationship of sLOX-1 with both fatal events and plaque progression in patients with acute coronary syndromes (ACS). METHODS AND RESULTS Plasma sLOX-1 was assessed at baseline in ACS and chronic coronary syndrome (CCS) patients prospectively recruited in the multicentre SPUM-ACS study, with sex- and age-matched healthy subjects serving as additional controls (n = 2924). Compared with both CCS and controls, ACS patients showed markedly elevated sLOX-1 levels (median, 2.00 and 2.00 vs. 35.08 pg/mL; P < 0.0001) which were independently associated with increased mortality risk over 30-day [tertile (T)3: adjusted hazard ratio (HR), 3.11; 95% confidence interval (CI), 1.44-10.61; P = 0.0055] and 1-year intervals (T3: adjusted HR, 2.04; 95% CI, 1.19-3.92; P = 0.0098). Results remained consistent after adjustment for GRACE 2.0 (T3: adjusted HR, 1.86; 95% CI, 1.04-3.74; P = 0.0391) and were primarily driven by the pronounced relationship of sLOX-1 with cardiovascular mortality at 30 days (T3: adjusted HR, 3.81; 95% CI, 1.62-19.62; P = 0.0036) and at 1 year (T3: adjusted HR, 2.29; 95% CI, 1.19-5.34; P = 0.0148). In ACS patients undergoing serial intracoronary imaging and statin therapy, sLOX-1 dropped significantly in those with coronary plaque regression at 1 year (ΔsLOX-1: -4.64 ± 1.80; P = 0.0057), and showed a good discrimination for predicting plaque progression (area under the curve = 0.74; 95% CI, 0.59-0.86; P = 0.0031). CONCLUSION Plasma sLOX-1 levels are increased during ACS and predict fatal events beyond traditional and emerging risk factors. Persistently high sLOX-1 associates with coronary plaque progression in patients with established ASCVD. CLINICAL TRIAL REGISTRATION NCT01000701.
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Affiliation(s)
- Simon Kraler
- Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Zurich, Switzerland
| | - Florian A Wenzl
- Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Zurich, Switzerland
| | - Georgios Georgiopoulos
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- School of Biomedical Engineering and Imaging Sciences, King's College, London, UK
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens School of Health Sciences, Athens, Greece
| | - Slayman Obeid
- University Heart Center, Department of Cardiology, University Hospital, Zurich, Switzerland
| | - Luca Liberale
- Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Zurich, Switzerland
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | | | - Olivier Muller
- Department of Cardiology, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland
| | - François Mach
- Cardiology, University Hospital Geneva, Geneva, Switzerland
| | | | | | - Martin O Schmiady
- University Heart Center, Department of Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland
- Department of Congenital Cardiovascular Surgery, University Children's Hospital, Zurich, Switzerland
| | - Konstantinos Stellos
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Department of Cardiology, Freeman Hospital, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Department of Cardiovascular Research, European Center for Angioscience (ECAS), Heidelberg University, Mannheim, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Kimon Stamatelopoulos
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens School of Health Sciences, Athens, Greece
| | - Giovanni G Camici
- Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Zurich, Switzerland
- University Heart Center, Department of Cardiology, University Hospital, Zurich, Switzerland
- Department of Research and Education, University Hospital Zurich, Zurich, Switzerland
| | - Annie Srdic
- University Heart Center, Department of Cardiology, University Hospital, Zurich, Switzerland
| | - Francesco Paneni
- Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Zurich, Switzerland
- University Heart Center, Department of Cardiology, University Hospital, Zurich, Switzerland
| | - Alexander Akhmedov
- Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Zurich, Switzerland
| | - Thomas F Lüscher
- Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Zurich, Switzerland
- Research, Education & Development, Royal Brompton and Harefield Hospitals and Imperial College, Sydney Street, London SW3 6NP, UK
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13
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Sposito AC. Soluble LOX-1 levels during acute coronary syndrome: a potent and multifaceted warning sign for cardiovascular risk. Eur Heart J 2022; 43:1861-1863. [PMID: 35567567 DOI: 10.1093/eurheartj/ehac173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
- Andrei C Sposito
- Atherosclerosis and Vascular Biology Laboratory (Atherolab), State University of Campinas (Unicamp), 13084-971, Campinas, Sao Paulo, Brazil
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14
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Kott KA, Bishop M, Yang CHJ, Plasto TM, Cheng DC, Kaplan AI, Cullen L, Celermajer DS, Meikle PJ, Vernon ST, Figtree GA. Biomarker Development in Cardiology: Reviewing the Past to Inform the Future. Cells 2022; 11:588. [PMID: 35159397 PMCID: PMC8834296 DOI: 10.3390/cells11030588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/27/2022] [Accepted: 02/05/2022] [Indexed: 12/29/2022] Open
Abstract
Cardiac biomarkers have become pivotal to the clinical practice of cardiology, but there remains much to discover that could benefit cardiology patients. We review the discovery of key protein biomarkers in the fields of acute coronary syndrome, heart failure, and atherosclerosis, giving an overview of the populations they were studied in and the statistics that were used to validate them. We review statistical approaches that are currently in use to assess new biomarkers and overview a framework for biomarker discovery and evaluation that could be incorporated into clinical trials to evaluate cardiovascular outcomes in the future.
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Affiliation(s)
- Katharine A. Kott
- Cardiovascular Discovery Group, Kolling Institute of Medical Research, University of Sydney, St Leonards 2065, Australia; (K.A.K.); (S.T.V.)
- Department of Cardiology, Royal North Shore Hospital, St Leonards 2065, Australia
- Sydney Medical School, University of Sydney, Camperdown 2050, Australia; (C.H.J.Y.); (T.M.P.); (D.C.C.); (A.I.K.); (D.S.C.)
| | - Michael Bishop
- School of Medicine and Public Health, University of Newcastle, Kensington 2033, Australia;
| | - Christina H. J. Yang
- Sydney Medical School, University of Sydney, Camperdown 2050, Australia; (C.H.J.Y.); (T.M.P.); (D.C.C.); (A.I.K.); (D.S.C.)
| | - Toby M. Plasto
- Sydney Medical School, University of Sydney, Camperdown 2050, Australia; (C.H.J.Y.); (T.M.P.); (D.C.C.); (A.I.K.); (D.S.C.)
| | - Daniel C. Cheng
- Sydney Medical School, University of Sydney, Camperdown 2050, Australia; (C.H.J.Y.); (T.M.P.); (D.C.C.); (A.I.K.); (D.S.C.)
| | - Adam I. Kaplan
- Sydney Medical School, University of Sydney, Camperdown 2050, Australia; (C.H.J.Y.); (T.M.P.); (D.C.C.); (A.I.K.); (D.S.C.)
| | - Louise Cullen
- Emergency and Trauma Centre, Royal Brisbane and Women’s Hospital, Herston 4029, Australia;
| | - David S. Celermajer
- Sydney Medical School, University of Sydney, Camperdown 2050, Australia; (C.H.J.Y.); (T.M.P.); (D.C.C.); (A.I.K.); (D.S.C.)
- Department of Cardiology, Royal Prince Alfred Hospital, Camperdown 2050, Australia
- The Heart Research Institute, Newtown 2042, Australia
| | - Peter J. Meikle
- Baker Heart and Diabetes Institute, Melbourne 3004, Australia;
| | - Stephen T. Vernon
- Cardiovascular Discovery Group, Kolling Institute of Medical Research, University of Sydney, St Leonards 2065, Australia; (K.A.K.); (S.T.V.)
- Department of Cardiology, Royal North Shore Hospital, St Leonards 2065, Australia
- Sydney Medical School, University of Sydney, Camperdown 2050, Australia; (C.H.J.Y.); (T.M.P.); (D.C.C.); (A.I.K.); (D.S.C.)
| | - Gemma A. Figtree
- Cardiovascular Discovery Group, Kolling Institute of Medical Research, University of Sydney, St Leonards 2065, Australia; (K.A.K.); (S.T.V.)
- Department of Cardiology, Royal North Shore Hospital, St Leonards 2065, Australia
- Sydney Medical School, University of Sydney, Camperdown 2050, Australia; (C.H.J.Y.); (T.M.P.); (D.C.C.); (A.I.K.); (D.S.C.)
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15
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Circulating Biomarkers Reflecting Destabilization Mechanisms of Coronary Artery Plaques: Are We Looking for the Impossible? Biomolecules 2021; 11:biom11060881. [PMID: 34198543 PMCID: PMC8231770 DOI: 10.3390/biom11060881] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/11/2021] [Accepted: 06/12/2021] [Indexed: 12/12/2022] Open
Abstract
Despite significant strides to mitigate the complications of acute coronary syndrome (ACS), this clinical entity still represents a major global health burden. It has so far been well-established that most of the plaques leading to ACS are not a result of gradual narrowing of the vessel lumen, but rather a result of sudden disruption of vulnerable atherosclerotic plaques. As most of the developed imaging modalities for vulnerable plaque detection are invasive, multiple biomarkers were proposed to identify their presence. Owing to the pivotal role of lipids and inflammation in the pathophysiology of atherosclerosis, most of the biomarkers originated from one of those processes, whereas recent advancements in molecular sciences shed light on the use of microRNAs. Yet, at present there are no clinically implemented biomarkers or any other method for that matter that could non-invasively, yet reliably, diagnose the vulnerable plaque. Hence, in this review we summarized the available knowledge regarding the pathophysiology of plaque instability, the current evidence on potential biomarkers associated with plaque destabilization and finally, we discussed if search for biomarkers could one day bring us to non-invasive, cost-effective, yet valid way of diagnosing the vulnerable, rupture-prone coronary artery plaques.
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16
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Kook H, Jang DH, Kim JH, Cho JY, Joo HJ, Cho SA, Park JH, Hong SJ, Yu CW, Lim DS. Identification of plaque ruptures using a novel discriminative model comprising biomarkers in patients with acute coronary syndrome. Sci Rep 2020; 10:20228. [PMID: 33214686 PMCID: PMC7677551 DOI: 10.1038/s41598-020-77413-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 10/26/2020] [Indexed: 12/11/2022] Open
Abstract
Soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1), neutrophil gelatinase-associated lipocalin (NGAL), and matrix metalloproteinase-9 (MMP-9) are inflammatory biomarkers involved in plaque destabilization resulting in acute coronary syndrome (ACS). This study aimed to investigate the diagnostic value of a combination of biomarkers to discriminate plaque ruptures in the setting of ACS. Eighty-five ACS patients with optical coherence tomography (OCT) images of the culprit plaque were included and categorized into two groups: ACS with plaque rupture (Rupture group, n = 42) or without plaque rupture (Non-rupture group, n = 43) verified by OCT. A discriminative model of plaque rupture using several biomarkers was developed and validated. The Rupture group had higher white blood cell (WBC) counts and peak creatine kinase-myocardial band (CK-MB) levels (13.39 vs. 2.69 ng/mL, p = 0.0016). sLOX-1 (227.9 vs. 51.7 pg/mL, p < 0.0001) and MMP-9 (13.4 vs. 6.45 ng/mL, p = 0.0313) levels were significantly higher in the Rupture group, whereas NGAL showed a trend without statistical significance (59.03 vs. 53.80 ng/mL, p = 0.093). Receiver operating characteristic curves to differentiate Rupture group from Non-rupture group calculated the area under the curve for sLOX-1 (p < 0.001), MMP-9 (p = 0.0274), and NGAL (p = 0.0874) as 0.763, 0.645, and 0.609, respectively. A new combinatorial discriminative model including sLOX-1, MMP-9, WBC count, and the peak CK-MB level showed an area under the curve of 0.8431 (p < 0.001). With a cut-off point of 0.614, the sensitivity and specificity of plaque rupture were 62.2% and 97.6%, respectively. The new discriminative model using sLOX-1, MMP-9, WBC count, and peak CK-MB levels could better identify plaque rupture than each individual biomarker in ACS patients.
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Affiliation(s)
- Hyungdon Kook
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, #73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Duck Hyun Jang
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, #73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Jong-Ho Kim
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, #73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Jae-Young Cho
- Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Medical Center, Iksan, Korea
| | - Hyung Joon Joo
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, #73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Sang-A Cho
- Health Insurance Review and Assessment Service, Wonju, Korea
| | - Jae Hyoung Park
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, #73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Soon Jun Hong
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, #73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Cheol Woong Yu
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, #73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea.
| | - Do-Sun Lim
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, #73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea.
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17
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Barreto J, Karathanasis SK, Remaley A, Sposito AC. Role of LOX-1 (Lectin-Like Oxidized Low-Density Lipoprotein Receptor 1) as a Cardiovascular Risk Predictor: Mechanistic Insight and Potential Clinical Use. Arterioscler Thromb Vasc Biol 2020; 41:153-166. [PMID: 33176449 DOI: 10.1161/atvbaha.120.315421] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Atherosclerosis, the underlying cause of cardiovascular disease (CVD), is a worldwide cause of morbidity and mortality. Reducing ApoB-containing lipoproteins-chiefly, LDL (low-density lipoprotein)-has been the main strategy for reducing CVD risk. Although supported by large randomized clinical trials, the persistence of residual cardiovascular risk after effective LDL reduction has sparked an intense search for other novel CVD biomarkers and therapeutic targets. Recently, Lox-1 (lectin-type oxidized LDL receptor 1), an innate immune scavenger receptor, has emerged as a promising target for early diagnosis and cardiovascular risk prediction and is also being considered as a treatment target. Lox-1 was first described as a 50 kDa transmembrane protein in endothelial cells responsible for oxLDL (oxidized LDL) recognition, triggering downstream pathways that intensify atherosclerosis via endothelial dysfunction, oxLDL uptake, and apoptosis. Lox-1 is also expressed in platelets, where it enhances platelet activation, adhesion to endothelial cells, and ADP-mediated aggregation, thereby favoring thrombus formation. Lox-1 was also identified in cardiomyocytes, where it was implicated in the development of cardiac fibrosis and myocyte apoptosis, the main determinants of cardiac recovery following an ischemic insult. Together, these findings have revealed that Lox-1 is implicated in all the main steps of atherosclerosis and has encouraged the development of immunoassays for measurement of sLox-1 (serum levels of soluble Lox-1) to be used as a potential CVD biomarker. Finally, the recent development of synthetic Lox-1 inhibitors and neutralizing antibodies with promising results in animal models has made Lox-1 a target for drug development. In this review, we discuss the main findings regarding the role of Lox-1 in the development, diagnosis, and therapeutic strategies for CVD prevention and treatment.
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Affiliation(s)
- Joaquim Barreto
- Atherosclerosis and Vascular Biology Lab (Atherolab), Clinical Research Center, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Brazil (J.B., A.C.S.)
| | - Sotirios K Karathanasis
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (S.K.K., A.R.)
- NeoProgen, Baltimore, MD (S.K.K.)
| | - Alan Remaley
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (S.K.K., A.R.)
| | - Andrei C Sposito
- Atherosclerosis and Vascular Biology Lab (Atherolab), Clinical Research Center, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Brazil (J.B., A.C.S.)
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18
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Search for Reliable Circulating Biomarkers to Predict Carotid Plaque Vulnerability. Int J Mol Sci 2020; 21:ijms21218236. [PMID: 33153204 PMCID: PMC7662861 DOI: 10.3390/ijms21218236] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/30/2020] [Accepted: 11/01/2020] [Indexed: 02/06/2023] Open
Abstract
Atherosclerosis is responsible for 20% of ischemic strokes, and the plaques from the internal carotid artery the most frequently involved. Lipoproteins play a key role in carotid atherosclerosis since lipid accumulation contributes to plaque progression and chronic inflammation, both factors leading to plaque vulnerability. Carotid revascularization to prevent future vascular events is reasonable in some patients with high-grade carotid stenosis. However, the degree of stenosis alone is not sufficient to decide upon the best clinical management in some situations. In this context, it is essential to further characterize plaque vulnerability, according to specific characteristics (lipid-rich core, fibrous cap thinning, intraplaque hemorrhage). Although these features can be partly detected by imaging techniques, identifying carotid plaque vulnerability is still challenging. Therefore, the study of circulating biomarkers could provide adjunctive criteria to predict the risk of atherothrombotic stroke. In this regard, several molecules have been found altered, but reliable biomarkers have not been clearly established yet. The current review discusses the concept of vulnerable carotid plaque, and collects existing information about putative circulating biomarkers, being particularly focused on lipid-related and inflammatory molecules.
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19
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Markstad H, Edsfeldt A, Yao Mattison I, Bengtsson E, Singh P, Cavalera M, Asciutto G, Björkbacka H, Fredrikson GN, Dias N, Volkov P, Orho-Melander M, Nilsson J, Engström G, Gonçalves I. High Levels of Soluble Lectinlike Oxidized Low-Density Lipoprotein Receptor-1 Are Associated With Carotid Plaque Inflammation and Increased Risk of Ischemic Stroke. J Am Heart Assoc 2020; 8:e009874. [PMID: 30744454 PMCID: PMC6405674 DOI: 10.1161/jaha.118.009874] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background When the lectinlike oxidized low-density lipoprotein (ox LDL) receptor-1 ( LOX -1), a scavenger receptor for ox LDL , binds ox LDL , processes leading to endothelial dysfunction and inflammation are promoted. We aimed to study release mechanisms of LOX -1 and how circulating levels of soluble LOX -1 ( sLOX -1) relate to plaque inflammation and future risk for ischemic stroke. Methods and Results Endothelial cells and leukocytes were used to study release of sLOX -1. Plasma levels of sLOX -1 were determined in 4703 participants in the Malmö Diet and Cancer cohort. Incidence of ischemic stroke was monitored. For 202 patients undergoing carotid endarterectomy, levels of sLOX -1 were analyzed in plasma and plaque homogenates and related to plaque inflammation factors. Endothelial cells released sLOX -1 when exposed to ox LDL . A total of 257 subjects experienced stroke during a mean follow-up of 16.5 years. Subjects in the highest tertile of sLOX -1 had a stroke hazard ratio of 1.75 (95% CI, 1.28-2.39) compared with those in the lowest tertile after adjusting for age and sex. The patients undergoing carotid endarterectomy had a significant association between plasma sLOX -1 and the plaque content of sLOX -1 ( r=0.209, P=0.004). Plaques with high levels of sLOX -1 had more ox LDL , proinflammatory cytokines, and matrix metalloproteinases. Conclusions Our findings demonstrate that ox LDL induces the release of sLOX -1 from endothelial cells and that circulating levels of sLOX -1 correlate with carotid plaque inflammation and risk for ischemic stroke. These observations provide clinical support to experimental studies implicating LOX -1 in atherosclerosis and its possible role as target for cardiovascular intervention.
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Affiliation(s)
- Hanna Markstad
- 1 Center for Medical Imaging and Physiology Skåne University Hospital Lund University Lund Sweden.,2 Experimental Cardiovascular Research Unit Clinical Research Center Clinical Sciences Malmö Lund University Malmö Sweden
| | - Andreas Edsfeldt
- 2 Experimental Cardiovascular Research Unit Clinical Research Center Clinical Sciences Malmö Lund University Malmö Sweden.,3 Department of Cardiology Skåne University Hospital Malmö Sweden
| | - Ingrid Yao Mattison
- 2 Experimental Cardiovascular Research Unit Clinical Research Center Clinical Sciences Malmö Lund University Malmö Sweden
| | - Eva Bengtsson
- 2 Experimental Cardiovascular Research Unit Clinical Research Center Clinical Sciences Malmö Lund University Malmö Sweden
| | - Pratibha Singh
- 2 Experimental Cardiovascular Research Unit Clinical Research Center Clinical Sciences Malmö Lund University Malmö Sweden
| | - Michele Cavalera
- 2 Experimental Cardiovascular Research Unit Clinical Research Center Clinical Sciences Malmö Lund University Malmö Sweden
| | - Giuseppe Asciutto
- 4 Vascular Center, Malmö, Sweden Skåne University Hospital Malmö Sweden
| | - Harry Björkbacka
- 2 Experimental Cardiovascular Research Unit Clinical Research Center Clinical Sciences Malmö Lund University Malmö Sweden
| | - Gunilla Nordin Fredrikson
- 2 Experimental Cardiovascular Research Unit Clinical Research Center Clinical Sciences Malmö Lund University Malmö Sweden
| | - Nuno Dias
- 4 Vascular Center, Malmö, Sweden Skåne University Hospital Malmö Sweden
| | - Petr Volkov
- 5 Clinical Sciences Malmö Lund University Malmö Sweden
| | | | - Jan Nilsson
- 2 Experimental Cardiovascular Research Unit Clinical Research Center Clinical Sciences Malmö Lund University Malmö Sweden
| | | | - Isabel Gonçalves
- 2 Experimental Cardiovascular Research Unit Clinical Research Center Clinical Sciences Malmö Lund University Malmö Sweden.,3 Department of Cardiology Skåne University Hospital Malmö Sweden
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20
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Yoshida K, Miyamoto S. Stratification by Multidimensional Approach for Rational Treatment of Asymptomatic Carotid Stenosis (SMART-K Study): Study Protocol. Neurol Med Chir (Tokyo) 2020; 60:10-16. [PMID: 31708514 PMCID: PMC6970068 DOI: 10.2176/nmc.st.2019-0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
With recent advances in medical treatments for carotid artery stenosis (CS), indications for carotid surgery should be more carefully considered for asymptomatic CS (ACS). Accurate stratification of ACS should be based on the risk of cerebral infarction, and subgroups of patients more likely to benefit from surgical treatment should be differentiated. Magnetic resonance imaging (MRI) offers a non-invasive, accurate modality for characterizing carotid plaque. Intraplaque hemorrhage (IPH) seems the most promising feature of vulnerable plaque detectable by MRI. Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) is a type II membrane protein of the C-type lectin family with an extracellular domain that can be proteolytically cleaved and released as a soluble form (sLOX-1). This sLOX-1 plays a key role in the pathogenesis of atherosclerosis, and elevated sLOX-1 concentrations correlate with thin or ruptured fibrous caps in patients with acute coronary syndrome. This ongoing study aims to clarify the incidence of ischemic stroke in patients with ACS and IPH confirmed by MRI, and to assess whether sLOX-1 could provide a biomarker for risk of future ischemic events. The study population comprises patients with ACS (>60% area stenosis) associated with MRI-diagnosed IPH receiving follow-up under medical treatment. Primary endpoints comprise transient ischemic attack, stroke or amaurosis resulting from concerned CS. Secondary endpoints comprise any stroke or surgical treatment for progressive luminal stenosis. The target number of patients is 120 and the observational period is 36 months. The study results could help identify individuals with ACS who are refractory to medical therapy.
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Affiliation(s)
- Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine
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21
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Lee AS, Wang YC, Chang SS, Lo PH, Chang CM, Lu J, Burns AR, Chen CH, Kakino A, Sawamura T, Chang KC. Detection of a High Ratio of Soluble to Membrane-Bound LOX-1 in Aspirated Coronary Thrombi From Patients With ST-Segment-Elevation Myocardial Infarction. J Am Heart Assoc 2020; 9:e014008. [PMID: 31928155 PMCID: PMC7033847 DOI: 10.1161/jaha.119.014008] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background The circulating level of soluble lectin‐like oxidized low‐density lipoprotein receptor‐1 (sLOX‐1) is a valuable biomarker of acute myocardial infarction (AMI). The most electronegative low‐density lipoprotein, L5, signals through LOX‐1 to trigger atherogenesis. We examined the characteristics of LOX‐1 and the role of L5 in aspirated coronary thrombi of AMI patients. Methods and Results Intracoronary thrombi were aspirated by performing interventional thrombosuction in patients with ST‐segment–elevation myocardial infarction (STEMI; n=32) or non–ST‐segment–elevation myocardial infarction (n=12). LOX‐1 level and the ratio of sLOX‐1 to membrane‐bound LOX‐1 were higher in thrombi of STEMI patients than in those of non–ST‐segment–elevation myocardial infarction patients. In all aspirated thrombi, LOX‐1 colocalized with apoB100. When we explored the role of L5 in AMI, deconvolution microscopy showed that particles of L5 but not L1 (the least electronegative low‐density lipoprotein) quickly formed aggregates prone to retention in thrombi. Treating human monocytic THP‐1 cells with L5 or L1 showed that L5 induced cellular adhesion and promoted the differentiation of monocytes into macrophages in a dose‐dependent manner. In a second cohort of AMI patients, the L5 percentage and plasma concentration of sLOX‐1 were higher in STEMI patients (n=33) than in non–ST‐segment–elevation myocardial infarction patients (n=25), and sLOX‐1 level positively correlated with L5 level in AMI patients. Conclusions The level of LOX‐1 and the ratio of sLOX‐1 to membrane‐bound LOX‐1 in aspirated thrombi, as well as the circulating level of sLOX‐1 were higher in STEMI patients than in non–ST‐segment–elevation myocardial infarction patients. L5 may play a role in releasing a high level of sLOX‐1 into the circulation of STEMI patients.
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Affiliation(s)
- An-Sheng Lee
- Department of Medicine Mackay Medical College New Taipei City Taiwan.,Cardiovascular Research Laboratory China Medical University Hospital Taichung Taiwan
| | - Yu-Chen Wang
- Cardiovascular Research Laboratory China Medical University Hospital Taichung Taiwan.,Division of Cardiovascular Medicine Asia University Hospital Taichung Taiwan.,Department of Biotechnology Asia University Taichung Taiwan.,Division of Cardiovascular Medicine China Medical University Hospital Taichung Taiwan
| | - Shih-Sheng Chang
- Division of Cardiovascular Medicine China Medical University Hospital Taichung Taiwan
| | - Ping-Hang Lo
- Division of Cardiovascular Medicine China Medical University Hospital Taichung Taiwan
| | - Chia-Ming Chang
- Cardiovascular Research Laboratory China Medical University Hospital Taichung Taiwan
| | - Jonathan Lu
- Vascular and Medicinal Research Texas Heart Institute Houston TX.,InVitro Cell Research LLC Englewood NJ
| | - Alan R Burns
- College of Optometry University of Houston Houston TX
| | - Chu-Huang Chen
- Vascular and Medicinal Research Texas Heart Institute Houston TX.,New York Heart Research Foundation Mineola NY
| | - Akemi Kakino
- Department of Life Innovation Institute for Biomedical Sciences Shinshu University Matsumoto Japan.,Department of Molecular Pathophysiology Shinshu University School of Medicine Matsumoto Japan
| | - Tatsuya Sawamura
- Department of Life Innovation Institute for Biomedical Sciences Shinshu University Matsumoto Japan.,Department of Molecular Pathophysiology Shinshu University School of Medicine Matsumoto Japan
| | - Kuan-Cheng Chang
- Cardiovascular Research Laboratory China Medical University Hospital Taichung Taiwan.,Division of Cardiovascular Medicine China Medical University Hospital Taichung Taiwan.,Graduate Institute of Biomedical Sciences China Medical University Taichung Taiwan
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22
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Hofmann A, Brunssen C, Wolk S, Reeps C, Morawietz H. Soluble LOX-1: A Novel Biomarker in Patients With Coronary Artery Disease, Stroke, and Acute Aortic Dissection? J Am Heart Assoc 2020; 9:e013803. [PMID: 31902328 PMCID: PMC6988168 DOI: 10.1161/jaha.119.013803] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Anja Hofmann
- Division of Vascular Endothelium and Microcirculation Department of Medicine III Medical Faculty Carl Gustav Carus and University Hospital Carl Gustav Carus Dresden Technische Universität Dresden Dresden Germany.,Division of Vascular and Endovascular Surgery Department for Visceral-, Thoracic and Vascular Surgery Medical Faculty Carl Gustav Carus and University Hospital Carl Gustav Carus Dresden Technische Universität Dresden Dresden Germany
| | - Coy Brunssen
- Division of Vascular Endothelium and Microcirculation Department of Medicine III Medical Faculty Carl Gustav Carus and University Hospital Carl Gustav Carus Dresden Technische Universität Dresden Dresden Germany
| | - Steffen Wolk
- Division of Vascular and Endovascular Surgery Department for Visceral-, Thoracic and Vascular Surgery Medical Faculty Carl Gustav Carus and University Hospital Carl Gustav Carus Dresden Technische Universität Dresden Dresden Germany
| | - Christian Reeps
- Division of Vascular and Endovascular Surgery Department for Visceral-, Thoracic and Vascular Surgery Medical Faculty Carl Gustav Carus and University Hospital Carl Gustav Carus Dresden Technische Universität Dresden Dresden Germany
| | - Henning Morawietz
- Division of Vascular Endothelium and Microcirculation Department of Medicine III Medical Faculty Carl Gustav Carus and University Hospital Carl Gustav Carus Dresden Technische Universität Dresden Dresden Germany
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23
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Kobayashi N, Asai K, Tsurumi M, Shibata Y, Okazaki H, Shirakabe A, Goda H, Uchiyama S, Tani K, Takano M, Shimizu W. Impact of Accumulated Serum Uric Acid on Coronary Culprit Lesion Morphology Determined by Optical Coherence Tomography and Cardiac Outcomes in Patients with Acute Coronary Syndrome. Cardiology 2019; 141:190-198. [DOI: 10.1159/000496053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 12/05/2018] [Indexed: 11/19/2022]
Abstract
Objectives: We aimed to examine the relations of very high levels of serum uric acid (sUA) with features of culprit lesion plaque morphology determined by optical coherence tomography (OCT) and adverse clinical outcomes in patients with acute coronary syndrome (ACS). Methods: We retrospectively compared ACS patients according to sUA levels of > 8.0 mg/dL (n = 169), 7.1–8.0 mg/dL (n = 163), 6.1–7.0 mg/dL (n = 259), and ≤6.0 mg/dL (n = 717). Angiography and OCT findings were analyzed in patients with preintervention OCT and the 4 sUA groups (> 8.0 mg/dL, n = 61; 7.1–8.0 mg/dL, n = 72; 6.1–7.0 mg/dL, n = 131; and ≤6.0 mg/dL, n = 348) were compared. Results: Cardiogenic shock was more prevalent in ACS patients with sUA > 8.0 mg/dL (22% vs. 19% vs. 10% vs. 6%, p < 0.001). Plaque rupture was observed more prevalently by OCT in patients with sUA > 8.0 mg/dL (67% vs. 47% vs. 56% vs. 45%, p = 0.027). At the 2-year follow-up, Kaplan-Meier estimates showed higher cardiac mortality in patients with sUA > 8.0 mg/dL (25% vs. 12% vs. 5% vs. 5%, p < 0.001). After adjusting for traditional cardiovascular risk factors and creatinine levels, patients with sUA > 8.0 mg/dL showed a 4.5-fold increased risk in 2-year cardiac death by multivariate Cox proportional hazard analysis (hazard ratio 4.54, 95% confidence interval 2.98–6.91; p < 0.001). Conclusions: Very high sUA levels like > 8.0 mg/dL are the primary predictor of 2-year cardiac mortality and could partly be caused by adverse effects of accumulated sUA on plaque morphology in patients with ACS.
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24
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Relation of coronary culprit lesion morphology determined by optical coherence tomography and cardiac outcomes to preinfarction angina in patients with acute myocardial infarction. Int J Cardiol 2018; 269:356-361. [PMID: 30060967 DOI: 10.1016/j.ijcard.2018.07.074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/01/2018] [Accepted: 07/16/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND While preinfarction angina pectoris (pre-IA) is recognized as favorable effects on acute myocardial infarction (AMI), the detail has not been fully investigated. The aims of the current study were to clarify patient characteristics, lesion morphologies determined by optical coherence tomography (OCT), and cardiac outcomes related to pre-IA in patients with AMI. METHODS Clinical data and outcomes were compared between AMI patients with pre-IA (pre-IA group, n = 507) and without pre-IA (non-pre-IA group, n = 653). Angiography and OCT findings were analyzed in patients with pre-intervention OCT and compared between groups of pre-IA (n = 219) and non-pre-IA (n = 269). RESULTS ST-segment elevation myocardial infarction (61% vs. 75%, p < 0.001) and cardiogenic shock (8% vs. 14%, p = 0.001) were less prevalent in pre-IA group. Peak creatine kinase-MB levels were lower in pre-IA group (median 83 IU/mL vs. 126 IU/mL, p < 0.001). In pre-intervention coronary angiography findings, initial TIMI flow grade 0/1 (43% vs. 56%, p = 0.019) and Rentrop collateral circulation 0/1 (69% vs. 79%, p = 0.018) were less frequently observed in pre-IA than in non-pre-IA patients. In post-thrombectomy OCT images, plaque rupture (39% vs. 56%, p = 0.003) and red thrombi (42% vs. 54%, p = 0.027) were also less frequently observed in pre-IA group. Kaplan-Meier estimate survival curves showed that cardiac death at 12-months was lower in pre-IA group than in non-pre-IA group (6.9% vs. 10.1%, p = 0.036). CONCLUSIONS Patients with pre-IA had less severe AMI on admission, smaller infarction size, and more favorable long-term survival, which may be caused by difference of lesion morphology between patients with and without pre-IA.
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25
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Kobayashi N, Hata N, Tsurumi M, Shibata Y, Okazaki H, Shirakabe A, Takano M, Seino Y, Shimizu W. Relation of Coronary Culprit Lesion Morphology Determined by Optical Coherence Tomography and Cardiac Outcomes to Serum Uric Acid Levels in Patients With Acute Coronary Syndrome. Am J Cardiol 2018; 122:17-25. [PMID: 29678337 DOI: 10.1016/j.amjcard.2018.03.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 03/14/2018] [Accepted: 03/21/2018] [Indexed: 10/24/2022]
Abstract
The aims of the present study were to elucidate features of culprit lesion plaque morphology using optical coherence tomography (OCT) in relation to elevated serum uric acid (sUA) levels and to clarify the impact of sUA levels on adverse clinical outcomes in patients with acute coronary syndrome (ACS). Clinical data and outcomes were compared between ACS patients with sUA ≥6 mg/dl (high-sUA; n = 506) and sUA <6.0 mg/dl (low-sUA; n = 608). Angiography and OCT findings were analyzed in patients with preintervention OCT and compared between groups of high-sUA (n = 206) and low-sUA (n = 273). Patients with high-sUA were more frequently male (88% vs 74%, p <0.001), younger (median 65 years vs 67 years, p = 0.017), more obese (median body mass index; 24.3 kg/m2 vs 23.2 kg/m2, p <0.001), and had a more frequent history of hypertension (72% vs 62%, p <0.001). ACS with lung congestion or cardiogenic shock was more prevalent in patients with high-sUA (30% vs 13%, p <0.001). Plaque rupture (54% vs 42%, p = 0.021) and red thrombi (55% vs 41%, p = 0.010) were more prevalently observed by OCT in patients with high-sUA. Kaplan-Meier estimate survival curves showed that the 2-year cardiac mortality was higher in patients with high-sUA (12.1% vs 4.2%, p <0.001). The multivariate Cox proportional hazard analysis showed that sUA values independently and significantly predicted cardiac death within 2 years (hazard ratio 1.41 [95% confidence interval 1.26 to 1.57], p <0.001). In conclusion, sUA levels are associated with culprit lesion coronary plaque morphology and raised sUA levels affect cardiovascular mortality after adjusting for several cardiovascular risk factors.
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26
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Takasu S, Matsumoto S, Kanto Y, Iwadate K. Utility of soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) in the postmortem diagnosis of ischemic heart disease. J Forensic Leg Med 2018; 55:45-51. [DOI: 10.1016/j.jflm.2018.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 02/02/2018] [Accepted: 02/06/2018] [Indexed: 10/18/2022]
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27
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Li XM, Jin PP, Xue J, Chen J, Chen QF, Luan XQ, Zhang ZR, Yu TE, Cai ZY, Zhao K, Shao B. Role of sLOX-1 in intracranial artery stenosis and in predicting long-term prognosis of acute ischemic stroke. Brain Behav 2018; 8:e00879. [PMID: 29568681 PMCID: PMC5853620 DOI: 10.1002/brb3.879] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/26/2017] [Accepted: 10/22/2017] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The role of sLOX-1 in acute ischemic stroke still remains unclear. This study aims to demonstrate the value of sLOX-1 in evaluating degrees of intracranial artery stenosis and to predict prognosis in stroke. METHODS Two hundred and seventy-two patients were included in this study and basic data were collected within 72 hr on admission. We assessed the association between sLOX-1 levels and stroke conditions in one-year duration. After adjusting for potential confounders, regression analyses were performed. RESULTS We found that sLOX-1 levels were increased significantly in severe patients compared to the mild stroke group (p = .011). After adjusting confounders, sLOX-1 was associated with a poor functional outcome in patients with an adjusted OR of 2. 946 (95% CI, 1.788-4.856, p < .001). There was also positive correlation between sLOX-1 levels and the degrees of intracranial artery stenosis in the different groups (p = .029). CONCLUSIONS Our study demonstrated that sLOX-1 levels could be used to evaluate the severity of stroke and the degrees of intracranial artery stenosis. Furthermore, sLOX-1 could be exploited to predict the long-term functional outcome of stroke.
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Affiliation(s)
- Xian-Mei Li
- Department of Neurology First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Ping-Ping Jin
- Department of Neurology First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Jie Xue
- Department of Neurology Yangpu Hospital of Tongji University Shang Hai China
| | - Jie Chen
- Department of Neurology First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Qin-Fen Chen
- Department of Gastroenterology First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Xiao-Qian Luan
- Department of Neurology First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Zeng-Rui Zhang
- Department of Neurology First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Tie-Er Yu
- Department of Neurology First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Zheng-Yi Cai
- Department of Neurology First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Kai Zhao
- Department of Neurology First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Bei Shao
- Department of Neurology First Affiliated Hospital of Wenzhou Medical University Wenzhou China
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28
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Puttaruk P, Pipatsatitpong D, Siripurkpong P. Soluble lectin-like oxidized low density lipoprotein receptor-1 in metabolic syndrome. ASIAN BIOMED 2017. [DOI: 10.5372/1905-7415.0905.439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abstract
Background
Serum levels of soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) reflect increases in LOX-1 receptor expression associated with inflammation and metabolic disorders.
Objectives
To examine sLOX-1 levels in metabolic syndrome and association of sLOX-1 with classical risk factors, and with metabolic syndrome, a clustering of metabolic disorders associated with cardiovascular risk factors.
Methods
We selected 148 serum samples from patient participants with metabolic syndrome and 206 samples from patients with non-metabolic syndrome as controls, using the modified National Cholesterol Educational Program Adult Treatment Panel III (NCEP-ATP III) criteria.
Results
Levels of sLOX-1 were increased significantly in participants with metabolic syndrome (P < 0.001). Serum sLOX-1 was positively associated with body mass index (BMI), blood pressure, fasting plasma glucose, triglyceride, and total cholesterol, but negatively associated with high-density lipoprotein cholesterol. Analysis of serum sLOX-1 for metabolic syndrome showed 99.03% specificity and 100% sensitivity. The area under the receiver operating characteristic curve was 0.998 (95%CI 0.996-1.001, P < 0.001). A univariate analysis showed sLOX-1 was significantly correlated with metabolic syndrome, but was not after adjustment for sex, age, blood pressure, and BMI. Multivariate regression analysis found that being overweight (82.3; 95%CI 10.7–631.9), hyperglycemia (1.1; 95%CI 1.1–1.2), and hypertriglyceridemia (1.1; 95%CI 1.0–1.1) were significantly correlated with metabolic syndrome. HDL cholesterol was a protective factor (0.96; 95%CI: 0.93–0.99).
Conclusions
Serum sLOX-1 is a suitable biomarker for diagnosis of metabolic syndrome. However, univariate and multivariate analysis suggested that sLOX-1 may be a modulating factor, and not an independent risk factor.
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Affiliation(s)
- Palakorn Puttaruk
- Department of Medical Technology Laboratory , Thammasat University Hospital , Pathum Thani 12120 , Thailand
| | - Duangnate Pipatsatitpong
- Department of Medical Technology , Faculty of Allied Health Sciences , Thammasat University , Pathum Thani , 12120 , Thailand
| | - Pilaiwan Siripurkpong
- Department of Medical Technology , Faculty of Allied Health Sciences , Thammasat University , Pathum Thani 12120 , Thailand
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Huang W, Li Q, Chen X, Lin Y, Xue J, Cai Z, Zhang W, Wang H, Jin K, Shao B. Soluble lectin-like oxidized low-density lipoprotein receptor-1 as a novel biomarker for large-artery atherosclerotic stroke. Int J Neurosci 2017; 127:881-886. [PMID: 27967338 DOI: 10.1080/00207454.2016.1272601] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Serum soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) has been shown associated with the progression of atherosclerosis in endothelial cells. We sought to assess whether the baseline serum sLOX-1 levels are correlated with the presence and short-term functional outcome of large-artery atherosclerotic (LAA) stroke. METHODS The study recruited 241 subjects, including 148 consecutive patients with acute ischemic stroke with the subtype of LAA and 93 non-stroke controls. Clinical and laboratory data, including serum concentration of sLOX-1, were collected within 24 h of admission, and the severity of LAA stroke patients was evaluated by National Institutes of Health Stroke Scale score. And functional outcome was assessed by modified Rankin Scale three months after stroke. The association between sLOX-1 level and the functional outcome at three months was analyzed by multiple logistic regression models. RESULTS Serum levels of sLOX-1 in the LAA stroke patients were significantly higher as compared to normal controls (2.48 ± 0.93 ng/ml vs. 2.22 ± 0.79 ng/ml in the controls, t = 2.301, p = 0.022). The levels of serum sLOX-1 in patients with good outcome were significantly lower than those with poor outcome (2.39 ± 0.94 ng/ml vs. 2.77 ± 0.84 ng/ml, p = 0.032). After adjusting for potential confounders, sLOX-1 was still an independent predictor for the function outcome with an adjusted OR of 3.39 (95% CI, 1.61-7.11, p = 0.001). CONCLUSIONS The serum sLOX-1 level was higher in patients with LAA stroke, and it was an independent predictor of functional outcome in patients with LAA ischemic stroke.
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Affiliation(s)
- Wensi Huang
- a Department of Neurology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research , First Affiliated Hospital, Wenzhou Medical University , Wenzhou , China.,b Department of Neurology , The People's Hospital Of Pingyang , Wenzhou , China
| | - Qian Li
- a Department of Neurology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research , First Affiliated Hospital, Wenzhou Medical University , Wenzhou , China
| | - Xiaoli Chen
- a Department of Neurology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research , First Affiliated Hospital, Wenzhou Medical University , Wenzhou , China
| | - Yuanshao Lin
- a Department of Neurology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research , First Affiliated Hospital, Wenzhou Medical University , Wenzhou , China
| | - Jie Xue
- a Department of Neurology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research , First Affiliated Hospital, Wenzhou Medical University , Wenzhou , China
| | - Zhengyi Cai
- a Department of Neurology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research , First Affiliated Hospital, Wenzhou Medical University , Wenzhou , China
| | - Wanli Zhang
- a Department of Neurology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research , First Affiliated Hospital, Wenzhou Medical University , Wenzhou , China
| | - Hong Wang
- a Department of Neurology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research , First Affiliated Hospital, Wenzhou Medical University , Wenzhou , China
| | - Kunlin Jin
- a Department of Neurology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research , First Affiliated Hospital, Wenzhou Medical University , Wenzhou , China.,c Department of Pharmacology and Neuroscience , University of North Texas Health Science Center at Fort Worth , Fort Worth , TX , USA
| | - Bei Shao
- a Department of Neurology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research , First Affiliated Hospital, Wenzhou Medical University , Wenzhou , China
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30
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Blood biomarkers associated with neurological deterioration in patients with acute penetrating artery territory infarction: A multicenter prospective observational study. Int J Stroke 2016; 13:207-216. [DOI: 10.1177/1747493016677982] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background and purpose Neurological deterioration in acute penetrating artery territory infarction is unpredictable and associated with unfavorable clinical outcomes. The aim of this prospective study was to clarify the cause of neurological worsening and predict clinical outcomes using blood biomarkers. Methods Eight Japanese stroke centers participated. Blood samples were obtained within 24 h (the first sampling) and on day 7 in hospital (the second sampling) in patients with penetrating artery territory infarction, arriving within two days of stroke onset. Symptomatic worsening was defined as a minimum increase of one point on the National Institutes of Health Stroke Scale. Poor outcome was defined as a modified Rankin Scale score of ≥3 at 90 days after ictus. Results Of the 89 patients, 25 (28%) had symptomatic worsening, and 25 (28%) had a poor outcome. Although tumor necrosis factor-alpha, high-sensitivity C-reactive protein levels were significantly increased in both groups at the second sampling, soluble lectin-like oxidized low-density lipoprotein receptor-1, CD40 ligand, and pro-adrenomedullin levels were significantly increased and ADAMTS13 activity was decreased in symptomatic worsening patients ( p < 0.05 for all). After multivariate adjustment, a low number of CD34+ cells at the first sampling was an independent predictor of poor outcome (odds ratio, 0.20; 95% confidence interval, 0.04–0.74, p = 0.011, per 1 cell/µl increase). Conclusions Blood biomarkers associated with atherosclerotic processes seem to be an indication for symptomatic worsening, and the number of CD34+ cells may help to predict three-month functional outcome in patients with penetrating artery territory infarction.
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31
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Okamura T, Miura K, Sawamura T, Kadota A, Hisamatsu T, Fujiyoshi A, Miyamatsu N, Takashima N, Miyagawa N, Kadowaki T, Ohkubo T, Murakami Y, Nakamura Y, Ueshima H. Serum level of LOX-1 ligand containing ApoB is associated with increased carotid intima-media thickness in Japanese community-dwelling men, especially those with hypercholesterolemiaLOX-1 ligand and IMT in Japanese. J Clin Lipidol 2016; 10:172-80.e1. [DOI: 10.1016/j.jacl.2015.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 09/18/2015] [Accepted: 10/26/2015] [Indexed: 10/22/2022]
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Iannaccone M, Quadri G, Taha S, D'Ascenzo F, Montefusco A, Omede' P, Jang IK, Niccoli G, Souteyrand G, Yundai C, Toutouzas K, Benedetto S, Barbero U, Annone U, Lonni E, Imori Y, Biondi-Zoccai G, Templin C, Moretti C, Luscher TF, Gaita F. Prevalence and predictors of culprit plaque rupture at OCT in patients with coronary artery disease: a meta-analysis. Eur Heart J Cardiovasc Imaging 2015; 17:1128-37. [PMID: 26508517 DOI: 10.1093/ehjci/jev283] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 09/28/2015] [Indexed: 02/05/2023] Open
MESH Headings
- Acute Coronary Syndrome/diagnostic imaging
- Acute Coronary Syndrome/mortality
- Acute Coronary Syndrome/therapy
- Aged
- Angina, Stable/diagnostic imaging
- Angina, Stable/mortality
- Angina, Stable/therapy
- Angina, Unstable/diagnostic imaging
- Angina, Unstable/mortality
- Angina, Unstable/therapy
- Coronary Angiography/methods
- Coronary Artery Disease/diagnostic imaging
- Coronary Artery Disease/epidemiology
- Coronary Artery Disease/pathology
- Female
- Humans
- Male
- Middle Aged
- Myocardial Infarction/diagnostic imaging
- Myocardial Infarction/mortality
- Myocardial Infarction/therapy
- Plaque, Atherosclerotic/diagnostic imaging
- Plaque, Atherosclerotic/epidemiology
- Plaque, Atherosclerotic/pathology
- Predictive Value of Tests
- Prevalence
- Prognosis
- Risk Assessment
- Rupture, Spontaneous/diagnostic imaging
- Rupture, Spontaneous/epidemiology
- Survival Analysis
- Tomography, Optical Coherence/methods
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Affiliation(s)
- Mario Iannaccone
- Divisione di Cardiologia, Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Turin, Italy
| | - Giorgio Quadri
- Divisione di Cardiologia, Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Turin, Italy
| | - Salma Taha
- Divisione di Cardiologia, Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Turin, Italy
| | - Fabrizio D'Ascenzo
- Divisione di Cardiologia, Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Turin, Italy
| | - Antonio Montefusco
- Divisione di Cardiologia, Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Turin, Italy
| | - Pierluigi Omede'
- Divisione di Cardiologia, Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Turin, Italy
| | - Ik-Kyung Jang
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Geraud Souteyrand
- Pole Cardiologie, Centre Hospitalier Universitaire de Clermont-Ferrant, Clermont-Ferrant, France
| | - Chen Yundai
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | | | - Sara Benedetto
- Divisione di Cardiologia, Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Turin, Italy
| | - Umberto Barbero
- Divisione di Cardiologia, Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Turin, Italy
| | - Umberto Annone
- Divisione di Cardiologia, Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Turin, Italy
| | - Enrica Lonni
- Divisione di Cardiologia, Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Turin, Italy
| | - Yoichi Imori
- Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan University Hospital, Zurich, Switzerland
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | | | - Claudio Moretti
- Divisione di Cardiologia, Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Turin, Italy
| | | | - Fiorenzo Gaita
- Divisione di Cardiologia, Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Turin, Italy
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Clinical and Preclinical Use of LOX-1-Specific Antibodies in Diagnostics and Therapeutics. J Cardiovasc Transl Res 2015; 8:458-65. [PMID: 26385009 DOI: 10.1007/s12265-015-9655-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 09/07/2015] [Indexed: 01/01/2023]
Abstract
Lectin-like oxidized low-density lipoprotein receptor-1 (SR-E1, LOX-1, OLR1) was first discovered as a vascular receptor for modified lipoprotein particles nearly 20 years ago. Since then, in vitro and in vivo studies have demonstrated an association between LOX-1, a soluble form (sLOX-1) and a number of diseases including atherosclerosis, arthritis, hypertension and pre-eclampsia. However, converting such discoveries into tools and drugs for routine clinical use is dependent on translational preclinical and clinical studies but such studies have only begun to emerge in the past decade. In this review, we identify the key clinical applications and corresponding criteria that need to be addressed for the effective use of LOX-1-related probes and molecules for patient benefit in different disease states.
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Gradinaru D, Borsa C, Ionescu C, Prada GI. Oxidized LDL and NO synthesis--Biomarkers of endothelial dysfunction and ageing. Mech Ageing Dev 2015; 151:101-13. [PMID: 25804383 DOI: 10.1016/j.mad.2015.03.003] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 03/13/2015] [Accepted: 03/16/2015] [Indexed: 12/24/2022]
Abstract
Oxidized LDL (oxLDL) and nitric oxide (NO) exert contradictory actions within the vascular endothelium microenvironment influencing key events in atherogenesis. OxLDL and NO are so far regarded as representative parameters of oxidative stress and endothelial dysfunction, new targets in prevention, diagnosis and therapy of cardiovascular diseases, and also as candidate biomarkers in evaluating the human biological age. The aim of this review is to explore recent literature on molecular mechanisms and pathophysiological relationships between LDL oxidation, NO synthesis and vascular endothelium function/dysfunction in ageing, focusing on the following aspects: (1) the impact of metabolic status on both LDL oxidation and NO synthesis in relation with oxidative stress, (2) the use of oxidized LDL and NO activity as biomarkers in human studies reporting on cardiovascular outcomes, and (3) evidences supporting the importance of oxidized LDL and NO activity as relevant biomarkers in vascular ageing and age-related diseases.
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Affiliation(s)
- Daniela Gradinaru
- Ana Aslan National Institute of Gerontology and Geriatrics, 9 Caldarusani Street, Sector 1, P.O. Box 2-4, 011241 Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Faculty of Pharmacy, Department of Biochemistry, 6 Taian Vuia Street, Sector 2, 020956 Bucharest, Romania.
| | - Claudia Borsa
- Ana Aslan National Institute of Gerontology and Geriatrics, 9 Caldarusani Street, Sector 1, P.O. Box 2-4, 011241 Bucharest, Romania
| | - Cristina Ionescu
- Ana Aslan National Institute of Gerontology and Geriatrics, 9 Caldarusani Street, Sector 1, P.O. Box 2-4, 011241 Bucharest, Romania
| | - Gabriel Ioan Prada
- Ana Aslan National Institute of Gerontology and Geriatrics, 9 Caldarusani Street, Sector 1, P.O. Box 2-4, 011241 Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Faculty of Medicine, Department of Geriatrics and Gerontology, 37 Dionisie Lupu Street, Sector 2, 020021 Bucharest, Romania
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Sawamura T, Wakabayashi I, Okamura T. LOX-1 in atherosclerotic disease. Clin Chim Acta 2015; 440:157-63. [DOI: 10.1016/j.cca.2014.11.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 11/16/2014] [Accepted: 11/19/2014] [Indexed: 02/01/2023]
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36
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Higuma T, Abe N, Tateyama S, Endo T, Shibutani S, Yokoyama H, Hanada K, Yamada M, Tomita H, Hanada H, Osanai T, Kume N, Okumura K. Plasma soluble lectin-like oxidized low-density lipoprotein receptor-1 as a novel prognostic biomarker in patients with ST-segment elevation acute myocardial infarction. Circ J 2015; 79:641-8. [PMID: 25746549 DOI: 10.1253/circj.cj-14-0904] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) level is a reliable prognostic biomarker in acute coronary syndrome. However, it is unclear whether its plasma level at acute phase is related to the long-term prognosis in patients with ST-segment elevation acute myocardial infarction (STEMI). METHODS AND RESULTS: We prospectively examined the relation between plasma sLOX-1 level on admission and prognosis in 153 consecutive STEMI patients admitted within 24 h of onset. Primary percutaneous coronary intervention was performed in 144 patients. The patients were divided into 2 groups by the median value (71 pg/ml) of plasma sLOX-1 level on admission [sLOX-1 level ≤71 pg/ml (n=77) and >71 pg/ml (n=76)], and were followed for median of 1,156 days. All-cause mortality and the combined endpoints of major adverse cardiovascular events (MACE) defined as cardiovascular mortality and recurrent MI were both significantly higher in patients with sLOX-1 values above median than in those below median (25.0% vs. 3.9%, P<0.001, and 19.4% vs. 6.5%, P=0.019 by log-rank test, respectively). Even after adjustment for confounders, a level of sLOX-1 above median was an independent predictor for all-cause mortality (hazard ratio (HR): 5.893; 95% confidence interval (CI): 1.665-20.854, P=0.006) and MACE (HR: 3.457; 95% CI: 1.164-10.270, P=0.030). CONCLUSIONS Elevated plasma sLOX-1 level on admission independently predicts long-term all-cause mortality and MACE after STEMI.
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Affiliation(s)
- Takumi Higuma
- Department of Cardiology, Hirosaki University Graduate School of Medicine
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Shaw DJ, Seese R, Ponnambalam S, Ajjan R. The role of lectin-like oxidised low-density lipoprotein receptor-1 in vascular pathology. Diab Vasc Dis Res 2014; 11:410-8. [PMID: 25216847 DOI: 10.1177/1479164114547704] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The lectin-like oxidised low-density lipoprotein receptor-1 (LOX-1) is a vascular scavenger receptor that plays a central role in the pathogenesis of atherothrombotic disease, which remains the main cause of mortality in the Western population. Recent evidence indicates that targeting LOX-1 represents a credible strategy for the management vascular disease and the current review explores the role of this molecule in the diagnosis and treatment of atherosclerosis. LOX-1-mediated pro-atherogenic effects can be inhibited by anti-LOX-1 monoclonal antibodies and procyanidins, whereas downregulation of LOX-1 expression has been achieved by antisense oligonucleotides and a specific pyrrole-imidazole polyamide. Furthermore, LOX-1 can be utilised for plaque imaging using monoclonal antibodies and even the selective delivery of anti-atherosclerotic agents employing immunoliposome techniques. Also, plasma levels of the circulating soluble form of LOX-1 levels are elevated in atherosclerosis and therefore may constitute an additional diagnostic biomarker of vascular pathology.
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Affiliation(s)
- Daniel James Shaw
- Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK
| | - Rachel Seese
- Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK
| | - Sreenivasan Ponnambalam
- Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK
| | - Ramzi Ajjan
- Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK
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Soluble lectin-like oxidized low density lipoprotein receptor-1 as a biochemical marker for atherosclerosis-related diseases. DISEASE MARKERS 2013; 35:413-8. [PMID: 24198442 PMCID: PMC3809739 DOI: 10.1155/2013/716325] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 08/26/2013] [Indexed: 11/22/2022]
Abstract
Lectin-like oxidized low density lipoprotein receptor-1 (LOX-1), the main oxidized low-density lipoprotein (OxLDL) in endothelial cells, is upregulated in atherosclerotic lesions and is involved in several cellular processes that regulate the pathogenesis of atherosclerosis. The LOX-1 expressed on the cell surface can be proteolytically cleaved and released in a soluble form (sLOX-1) in the circulation under pathological conditions. Serum levels of sLOX-1, in fact, are elevated at the early stages of acute coronary syndrome and are associated with coronary plaque vulnerability and with the presence of multiple complex coronary lesions. Moreover, in subjects with stable CAD, levels of serum sLOX-1 are associated with the presence of lesions in the proximal and mid-segments of the left anterior descending artery that are the most prone to rupture; in subjects undergoing percutaneous coronary intervention, baseline preprocedural serum sLOX-1 levels are associated with the incidence of periprocedural myocardial infarction. Altogether, these findings suggest that circulating levels of sLOX-1 might be a diagnostic and prognostic marker for atherosclerotic-related events.
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