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Goodnough CL, Gross ER. Precision Medicine Considerations for the Management of Heart Disease and Stroke in East Asians. CARDIOLOGY PLUS 2020; 5:101-108. [PMID: 33954271 PMCID: PMC8095722 DOI: 10.4103/cp.cp_17_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Heart disease is the leading cause of death in Asian Americans. Importantly, people of East Asian descent are more likely to carry a loss-of-function point mutation in aldehyde dehydrogenase 2 (ALDH2), ALDH2*2, which reduces ALDH2 enzymatic activity by at least 40% relative to wild type ALDH2. Given the role of ALDH2 in removing toxic aldehydes from the cell, ALDH2 is intimately involved in the cardioprotective mechanisms of ischemic preconditioning and the pathophysiology of ischemia reperfusion injury. The ALDH2*2 variant is associated with an increased incidence of coronary artery disease, myocardial infarction, and stroke. Furthermore, this variant is associated with insensitivity to nitroglycerin, which is commonly prescribed in patients with cardiovascular disease. In this review, we discuss the genetic susceptibility and pathophysiology associated with the ALDH2*2 variant in regards to cardiovascular disease. We also present the considerations for the management of heart disease and stroke specific to East Asians carrying the ALDH2*2 genetic variant.
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Affiliation(s)
- Candida L Goodnough
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, California, USA
| | - Eric R Gross
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, California, USA
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2
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Montoye AHK, Mitchinson CJ, Townsend OR, Nemmers CH, Serkaian CN, Rider BC. Ischemic Preconditioning Does Not Improve Time Trial Performance in Recreational Runners. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2020; 13:1402-1417. [PMID: 33042381 PMCID: PMC7523890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Some evidence indicates that ischemic preconditioning (IPC) may positively affect endurance exercise performance, but IPC's effect on running performance is unclear. This study's purpose was to examine the effect of IPC on running performance in recreational runners. Participants (n=12) completed IPC, a sham (SH) condition, and a leg elevation without blood restriction (LE) control condition on separate days (order randomized). For IPC, blood was restricted using blood pressure cuffs inflated to 220 mmHg at the thigh. For SH, the cuffs were inflated to only 20 mmHg. For LE, participants positioned their legs at 90 degrees against a wall while laying supine. The duration of each protocol was 30 minutes (three 5-minute bouts with 5-minute breaks). Following each protocol, participants ran 2.4 kilometers as fast as possible on a motorized treadmill. Run time, heart rate, and perceived exertion were measured and statistically compared, using repeated-measures ANOVA, each 0.8 kilometers. There were no differences in heart rate or time trial performance across protocols (p>0.05; IPC, 612.5±61.2 sec; SH, 608.1±57.9 sec; LE, 612.7±59.1 sec). Rating of perceived exertion at 0.8 kilometers was significantly lower for the IPC protocol than SH in females only (~5.7%, or ~0.8 points on a 6-20 scale; p<0.05). Our IPC protocol did not improve running performance or physiological parameters during a time trial run in recreational runners. The performance benefit seen in this study's most fit individuals suggests that fitness level may influence IPC's efficacy for improving endurance running performance.
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Affiliation(s)
- Alexander H K Montoye
- Department of Integrative Physiology and Health Science, Alma College, Alma, MI, USA
| | | | | | | | | | - Brian C Rider
- Department of Kinesiology, Hope College, Holland, MI, USA
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Ruiz-Meana M, Boengler K, Garcia-Dorado D, Hausenloy DJ, Kaambre T, Kararigas G, Perrino C, Schulz R, Ytrehus K. Ageing, sex, and cardioprotection. Br J Pharmacol 2020; 177:5270-5286. [PMID: 31863453 DOI: 10.1111/bph.14951] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/13/2019] [Accepted: 11/18/2019] [Indexed: 12/12/2022] Open
Abstract
Translation of cardioprotective interventions aimed at reducing myocardial injury during ischaemia-reperfusion from experimental studies to clinical practice is an important yet unmet need in cardiovascular medicine. One particular challenge facing translation is the existence of demographic and clinical factors that influence the pathophysiology of ischaemia-reperfusion injury of the heart and the effects of treatments aimed at preventing it. Among these factors, age and sex are prominent and have a recognised role in the susceptibility and outcome of ischaemic heart disease. Remarkably, some of the most powerful cardioprotective strategies proven to be effective in young animals become ineffective during ageing. This article reviews the mechanisms and implications of the modulatory effects of ageing and sex on myocardial ischaemia-reperfusion injury and their potential effects on cardioprotective interventions. LINKED ARTICLES: This article is part of a themed issue on Risk factors, comorbidities, and comedications in cardioprotection. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.23/issuetoc.
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Affiliation(s)
- Marisol Ruiz-Meana
- Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autonoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red-CV (CIBER-CV), Madrid, Spain
| | - Kerstin Boengler
- Institute of Physiology, Justus-Liebig University Giessen, Giessen, Germany
| | - David Garcia-Dorado
- Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autonoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red-CV (CIBER-CV), Madrid, Spain
| | - Derek J Hausenloy
- Cardiovascular & Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore.,National Heart Research Institute Singapore, National Heart Centre, Singapore.,Yong Loo Lin School of Medicine, National University Singapore, Singapore.,The Hatter Cardiovascular Institute, University College London, London, UK.,The National Institute of Health Research, University College London Hospitals Biomedical Research Centre, Research & Development, London, UK.,Tecnologico de Monterrey, Centro de Biotecnologia-FEMSA, Nuevo Leon, Mexico
| | - Tuuli Kaambre
- Laboratory of Chemical Biology, National Institute of Chemical Physics and Biophysics, Tallinn, Estonia
| | - Georgios Kararigas
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlinand Berlin Institute of Health, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Cinzia Perrino
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Rainer Schulz
- Institute of Physiology, Justus-Liebig University Giessen, Giessen, Germany
| | - Kirsti Ytrehus
- Cardiovascular Research Group, Institute of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Panisello-Roselló A, Lopez A, Folch-Puy E, Carbonell T, Rolo A, Palmeira C, Adam R, Net M, Roselló-Catafau J. Role of aldehyde dehydrogenase 2 in ischemia reperfusion injury: An update. World J Gastroenterol 2018; 24:2984-2994. [PMID: 30038465 PMCID: PMC6054945 DOI: 10.3748/wjg.v24.i27.2984] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/28/2018] [Accepted: 06/30/2018] [Indexed: 02/06/2023] Open
Abstract
Aldehyde dehydrogenase 2 (ALDH2) is best known for its critical detoxifying role in liver alcohol metabolism. However, ALDH2 dysfunction is also involved in a wide range of human pathophysiological situations and is associated with complications such as cardiovascular diseases, diabetes mellitus, neurodegenerative diseases and aging. A growing body of research has shown that ALDH2 provides important protection against oxidative stress and the subsequent loading of toxic aldehydes such as 4-hydroxy-2-nonenal and adducts that occur in human diseases, including ischemia reperfusion injury (IRI). There is increasing evidence of its role in IRI pathophysiology in organs such as heart, brain, small intestine and kidney; however, surprisingly few studies have been carried out in the liver, where ALDH2 is found in abundance. This study reviews the role of ALDH2 in modulating the pathways involved in the pathophysiology of IRI associated with oxidative stress, autophagy and apoptosis. Special emphasis is placed on the role of ALDH2 in different organs, on therapeutic “preconditioning” strategies, and on the use of ALDH2 agonists such as Alda-1, which may become a useful therapeutic tool for preventing the deleterious effects of IRI in organ transplantation.
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Affiliation(s)
- Arnau Panisello-Roselló
- Department of Experimental Pathology, Institute of Biomedical Research of Barcelona (IIBB)-CSIC, Barcelona 08036, Spain
| | - Alexandre Lopez
- Centre Hepatobiliare, AP-HP Hôpital Paul Brousse, Villejuif 75008, France
| | - Emma Folch-Puy
- Department of Experimental Pathology, Institute of Biomedical Research of Barcelona (IIBB)-CSIC, Barcelona 08036, Spain
| | - Teresa Carbonell
- Department of Physiology, Faculty of Biology, Universitat de Barcelona, Barcelona 08036, Spain
| | - Anabela Rolo
- Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra 3004-517, Portugal
| | - Carlos Palmeira
- Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra 3004-517, Portugal
| | - René Adam
- Centre Hepatobiliare, AP-HP Hôpital Paul Brousse, Villejuif 75008, France
| | - Marc Net
- Institute Georges Lopez, Lissieu 69380, France
| | - Joan Roselló-Catafau
- Department of Experimental Pathology, Institute of Biomedical Research of Barcelona (IIBB)-CSIC, Barcelona 08036, Spain
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Allen K, Chuter KM, Fithon K, Marshall L, Hauton D. Modulation of the orthostatic blood pressure response by acute nitrate consumption is dependent upon ethnic origin. Clin Exp Pharmacol Physiol 2018; 45:1106-1117. [PMID: 30003580 DOI: 10.1111/1440-1681.13010] [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: 05/08/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 11/29/2022]
Abstract
Orthostatic stress triggers a response to maintain cerebral perfusion and prevent syncope. Given the hypotensive effects of inorganic nitrate this response to orthostasis may be altered by acute supplementation with inorganic nitrate and modified by ethnic origin. Caucasian and SE Asian (n = 30 for both), were recruited and subjected to an 'active stand test' and brachial artery blood pressure (BP), digit blood flow and ECG were recorded. Following inorganic nitrate supplementation, (10 mg/kg body mass) the tests were repeated. For both Caucasian and SE Asians transition to standing increased diastolic pressure (DP) and heart rate (HR) (P < 0.001 for both) and by calculation increased rate-pressure product (P < 0.001) and decreased pulse pressure (P < 0.01 for both) indicative of decreased ventricular filling. Nitrate supplementation decreased both DP (P < 0.001) and HR (P < 0.001). Assessment of HR variability suggested sympathetic nerve activity, was higher throughout in Caucasians (P < 0.05) coupled with higher parasympathetic tone (P < 0.01). Nitrate had no effect on cardiac autonomic nerve activity, as estimated using HR variability, for supine or standing subjects. The tachycardia and hypertension associated with orthostatic stress were preserved in both Caucasian and SE Asian subjects, however, we highlight possible differences in autonomic nervous system activity between Caucasians and SE Asians. SE Asians are resistant to the hypotensive effects of inorganic nitrate supplementation suggesting the absence of a crucial mechanism for activation of the nitrate-nitrite-nitric oxide system.
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Affiliation(s)
- Katie Allen
- Faculty of Maths & Physics, School of Food Science & Nutrition, University of Leeds, Leeds, UK
| | - Katie M Chuter
- Faculty of Maths & Physics, School of Food Science & Nutrition, University of Leeds, Leeds, UK
| | - Katherine Fithon
- Faculty of Maths & Physics, School of Food Science & Nutrition, University of Leeds, Leeds, UK
| | - Lisa Marshall
- Faculty of Maths & Physics, School of Food Science & Nutrition, University of Leeds, Leeds, UK
| | - David Hauton
- Department of Physiology, Anatomy & Genetics, University of Oxford, Oxford, UK.,Chemistry Research Laboratory, Department of Chemistry, University of Oxford, Oxford, UK
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Münzel T, Daiber A. Inorganic nitrite and nitrate in cardiovascular therapy: A better alternative to organic nitrates as nitric oxide donors? Vascul Pharmacol 2018; 102:1-10. [DOI: 10.1016/j.vph.2017.11.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/11/2017] [Accepted: 11/12/2017] [Indexed: 01/08/2023]
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Münzel T, Daiber A. The potential of aldehyde dehydrogenase 2 as a therapeutic target in cardiovascular disease. Expert Opin Ther Targets 2018; 22:217-231. [PMID: 29431026 DOI: 10.1080/14728222.2018.1439922] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Mitochondrial aldehyde dehydrogenase (ALDH-2) plays a major role in the ethanol detoxification pathway by removing acetaldehyde. Therefore, ALDH-2 inhibitors such as disulfiram represent the first therapeutic targeting of ALDH-2 for alcoholism therapy. Areas covered: Recently, ALDH-2 was identified as an essential bioactivating enzyme of the anti-ischemic organic nitrate nitroglycerin, bringing ALDH-2 again into the focus of clinical interest. Mechanistic studies on the nitroglycerin bioactivation process revealed that during bioconversion of nitroglycerin and in the presence of reactive oxygen and nitrogen species the active site thiols of ALDH-2 are oxidized and the enzyme activity is lost. Thus, ALDH-2 activity represents a useful marker for cardiovascular oxidative stress, a concept, which has been meanwhile supported by a number of animal disease models. Mechanistic studies on the protective role of ALDH-2 in different disease processes identified the detoxification of 4-hydroxynonenal by ALDH-2 as a fundamental process of cardiovascular, cerebral and antioxidant protection. Expert opinion: The most recent therapeutic exploitation of ALDH-2 includes activators of the enzyme such as Alda-1 but also cell-based therapies (ALDH-bright cells) that deserve further clinical characterization in the future.
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Affiliation(s)
- Thomas Münzel
- a Center for Cardiology, Cardiology 1 , Medical Center of the Johannes Gutenberg University , Mainz , Germany.,b Center for Thrombosis and Hemostasis (CTH) , Medical Center of the Johannes Gutenberg University , Mainz , Germany.,c Partner Site Rhine-Main , German Center for Cardiovascular Research (DZHK) , Mainz , Germany
| | - Andreas Daiber
- a Center for Cardiology, Cardiology 1 , Medical Center of the Johannes Gutenberg University , Mainz , Germany.,b Center for Thrombosis and Hemostasis (CTH) , Medical Center of the Johannes Gutenberg University , Mainz , Germany.,c Partner Site Rhine-Main , German Center for Cardiovascular Research (DZHK) , Mainz , Germany
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