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Micera S, Menciassi A, Cianferotti L, Gruppioni E, Lionetti V. Organ Neuroprosthetics: Connecting Transplanted and Artificial Organs with the Nervous System. Adv Healthc Mater 2024:e2302896. [PMID: 38656615 DOI: 10.1002/adhm.202302896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 04/01/2024] [Indexed: 04/26/2024]
Abstract
Implantable neural interfaces with the central and peripheral nervous systems are currently used to restore sensory, motor, and cognitive functions in disabled people with very promising results. They have also been used to modulate autonomic activities to treat diseases such as diabetes or hypertension. Here, this study proposes to extend the use of these technologies to (re-)establish the connection between new (transplanted or artificial) organs and the nervous system in order to increase the long-term efficacy and the effective biointegration of these solutions. In this perspective paper, some clinically relevant applications of this approach are briefly described. Then, the choices that neural engineers must implement about the type, implantation location, and closed-loop control algorithms to successfully realize this approach are highlighted. It is believed that these new "organ neuroprostheses" are going to become more and more valuable and very effective solutions in the years to come.
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Affiliation(s)
- Silvestro Micera
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, 56127, Italy
- Interdisciplinary Research Center Health Science, Scuola Superiore Sant'Anna, Pisa, 56127, Italy
- Bertarelli Foundation Chair in Translational Neuroengineering, Neuro-X Institute, School of Engineering, Ecole Polytechnique Federale de Lausanne (EPFL), Lausanne, 1015, Switzerland
| | - Arianna Menciassi
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, 56127, Italy
- Interdisciplinary Research Center Health Science, Scuola Superiore Sant'Anna, Pisa, 56127, Italy
| | - Luisella Cianferotti
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, 50121, Italy
| | | | - Vincenzo Lionetti
- Interdisciplinary Research Center Health Science, Scuola Superiore Sant'Anna, Pisa, 56127, Italy
- UOSVD Anesthesia and Resuscitation, Fondazione Toscana G. Monasterio, Pisa, 56127, Italy
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Rocca C, Pasqua T, Cerra MC, Angelone T. Cardiac Damage in Anthracyclines Therapy: Focus on Oxidative Stress and Inflammation. Antioxid Redox Signal 2020; 32:1081-1097. [PMID: 31928066 DOI: 10.1089/ars.2020.8016] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Significance: Despite their serious side effects, anthracyclines (ANTs) are the most prescribed chemotherapeutic drugs because of their strong efficacy in both solid and hematological tumors. A major limitation to ANTs clinical application is the severe cardiotoxicity observed both acutely and chronically. The mechanism underlying cardiac dysfunction under chemotherapy is mainly dependent on the generation of oxidative stress and systemic inflammation, both of which lead to progressive cardiomyopathy and heart failure. Recent Advances: Over the years, the iatrogenic ANTs-induced cardiotoxicity was believed to be simply given by iron metabolism and reactive oxygen species production; however, several experimental data indicate that ANTs may use alternative damaging mechanisms, such as topoisomerase 2β inhibition, inflammation, pyroptosis, immunometabolism, and autophagy. Critical Issues: In this review, we aimed at discussing ANTs-induced cardiac injury from different points of view, updating and focusing on oxidative stress and inflammation, since these pathways are not exclusive or independent from each other but they together importantly contribute to the complexity of ANTs-induced multifactorial cardiotoxicity. Future Directions: A deeper understanding of the mechanistic signaling leading to ANTs side effects could reveal crucial targeting molecules, thus representing strategic knowledge to promote better therapeutic efficacy and lower cardiotoxicity during clinical application.
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Affiliation(s)
- Carmine Rocca
- Laboratory of Cellular and Molecular Cardiovascular Physiology, Department of Biology, Ecology and Earth Sciences, University of Calabria, Rende, Italy
| | - Teresa Pasqua
- Laboratory of Cellular and Molecular Cardiovascular Physiology, Department of Biology, Ecology and Earth Sciences, University of Calabria, Rende, Italy
| | - Maria Carmela Cerra
- Laboratory of Organ and System Physiology, Department of Biology, Ecology and Earth Sciences, University of Calabria, Rende, Italy.,National Institute of Cardiovascular Research (INRC), Bologna, Italy
| | - Tommaso Angelone
- Laboratory of Cellular and Molecular Cardiovascular Physiology, Department of Biology, Ecology and Earth Sciences, University of Calabria, Rende, Italy.,National Institute of Cardiovascular Research (INRC), Bologna, Italy
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Pulignani S, Borghini A, Foffa I, Vecoli C, Ait-Alì L, Andreassi MG. Functional characterization and circulating expression profile of dysregulated microRNAs in BAV-associated aortopathy. Heart Vessels 2020; 35:432-440. [PMID: 31562552 DOI: 10.1007/s00380-019-01509-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 09/20/2019] [Indexed: 02/07/2023]
Abstract
Compelling evidence has shown that microRNAs (miRs) are involved in the pathophysiology of BAV-associated aortopathy. The purpose of this study was to assess the biological role as well as the circulating expression of two miRs (miR-424-3p and miR-3688-3p) that have been previously identified as significantly dysregulated in thoracic aortic aneurysm specimens of BAV patients. Bioinformatic tools were used to predict miR gene targets followed by functional validation transfecting synthetic miR mimics and negative controls into human aortic smooth muscle cells (HASMCs). Levels of miRs and target genes were evaluated by qRT-PCR. The circulating miR expression profile analysis was assessed on plasma samples collected from a cohort of 72 patients with aortopathy including 39 BAV (33 males; 58 ± 13 years) and 33 TAV patients (26 males; 67 ± 9 years). Computational analysis revealed that SMAD7 and YAP1 were potential targets of miR-424-3p and miR-3688-3p, respectively. Transfection with mimics confirmed a significantly decreased gene expression of SMAD7 and YAP1 compared to mimic negative control (p = 0.04 and p = 0.0005, respectively) or blank control (p = 0.01 and p = 0.0007, respectively). Overexpression of miR-3688-3p also significantly upregulated pro-apoptotic caspase-3 gene expression compared to mimic negative control (p = 0.02) or blank control (p = 0.01). Furthermore, a significant down-regulation of the circulating miR-424-3p was observed in BAV compared to TAV patients (p = 0.001). In multiple linear regression analysis, the aortic valve morphology (β = - 0.29, p = 0.04) and the presence of aortic stenosis (β = - 0.28, p = 0.03) had a significant effect on the miR-424-3p expression. In conclusion, our study demonstrated that miR-424-3p and miR-3688-3p directly targeted SMAD7 and YAP1 in HASMCs, pivotal genes of the TGF-β and Hippo-signaling pathways. Circulating miR-424-3p was also found to be significantly decreased in BAV patients when compared to TAV patients, especially in patients with aortic stenosis. Further large studies of well-characterized BAV patient cohorts are needed to define the clinical significance of the miR-424-3p.
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Affiliation(s)
- Silvia Pulignani
- Institute of Clinical Physiology (IFC), Via Moruzzi 1, 56124, Pisa, Italy
| | - Andrea Borghini
- Institute of Clinical Physiology (IFC), Via Moruzzi 1, 56124, Pisa, Italy
| | - Ilenia Foffa
- Institute of Clinical Physiology (IFC), Via Moruzzi 1, 56124, Pisa, Italy
| | - Cecilia Vecoli
- Institute of Clinical Physiology (IFC), Via Moruzzi 1, 56124, Pisa, Italy
| | - Lamia Ait-Alì
- Institute of Clinical Physiology (IFC), Via Moruzzi 1, 56124, Pisa, Italy
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Bigazzi F, Adorni MP, Puntoni M, Sbrana F, Lionetti V, Pino BD, Favari E, Recchia FA, Bernini F, Sampietro T. Analysis of Serum Cholesterol Efflux Capacity in a Minipig Model of Nonischemic Heart Failure. J Atheroscler Thromb 2017; 24:853-862. [PMID: 27980243 PMCID: PMC5556192 DOI: 10.5551/jat.37101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Aim: Circulating levels of high-density lipoprotein cholesterol (HDL-C) are decreased in patients with heart failure (HF). We tested whether HDL-C serum levels are associated with cardiac contractile dysfunction in a minipig HF model. Methods: Blood samples were collected from 13 adult male minipigs: 1) before pacemaker implantation, 2) 10 days after surgery, and 3) 3 weeks after high-rate LV pacing. Serum cholesterol efflux capacity (CEC), an index of HDL functionality, was assessed through four mechanisms: ATP Binding Cassette transporter A1 (ABCA1), ATP Binding Cassette transporter G1 (ABCG1), Scavenger Receptor-Class B Type I (SR-BI) and Passive Diffusion (PD). Results: HDL-C serum levels significantly decrease in minipigs with HF compared with baseline (p < 0.0001). Serum CEC mediated by PD and SR-BI, but not ABCA1 or ABCG1, significantly decrease in animals with HF (p < 0.05 and p < 0.005, respectively). Discussion: HDL-C serum levels and partial serum CEC reduction may play a pathophysiological role in the cardiac function decay sustained by high-rate LV pacing, opening new avenues to understand of the pathogenesis of nonischemic myocardial remodeling.
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Affiliation(s)
| | | | | | | | - Vincenzo Lionetti
- Fondazione Toscana Gabriele Monasterio.,Laboratory of Medical Science, Institute of Life Sciences, Scuola Superiore Sant'Anna
| | | | | | - Fabio A Recchia
- Laboratory of Medical Science, Institute of Life Sciences, Scuola Superiore Sant'Anna.,Department of Physiology, Temple University School of Medicine
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Prescimone T, Masotti S, D’Amico A, Caruso R, Cabiati M, Caselli C, Viglione F, Verde A, Del Ry S, Giannessi D. Cardiac molecular markers of programmed cell death are activated in end-stage heart failure patients supported by left ventricular assist device. Cardiovasc Pathol 2014; 23:272-82. [DOI: 10.1016/j.carpath.2014.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 03/24/2014] [Accepted: 04/07/2014] [Indexed: 10/25/2022] Open
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Prescimone T, D'Amico A, Caselli C, Cabiati M, Viglione F, Caruso R, Verde A, Del Ry S, Trivella MG, Giannessi D. Caspase-1 transcripts in failing human heart after mechanical unloading. Cardiovasc Pathol 2014; 24:11-8. [PMID: 25200478 DOI: 10.1016/j.carpath.2014.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 08/06/2014] [Accepted: 08/06/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Caspase (Casp)-1 has been indicated as a molecular target capable of preventing the progression of cardiovascular diseases, including heart failure (HF), due to its central role in promoting inflammation and cardiomyocyte loss. The aim of this study was to assess whether Left Ventricular Assist Device (LVAD) implantation modifies the inflammatory and apoptotic profile in the heart through the modulation of Casp-1 expression level. METHODS Cardiac tissue was collected from end-stage HF patients before LVAD implant (pre-LVAD group, n=22) and at LVAD removal (post-LVAD, n=6), and from stable HF patients on medical therapy without prior circulatory support (HTx, n=7) at heart transplantation, as control. The cardiac expression of Casp-1, of its inhibitors caspase recruitment domain (CARD) only protein (COP) and CARD family, member 18 (ICEBERG), was evaluated by real-time PCR in the three groups of patients. RESULTS Casp-1 was increased in the pre-LVAD group compared to HTx (p=0.006), while on the contrary the ICEBERG level was significantly decreased in pre-LVAD with respect to HTx patients (p<0.001); no difference in COP expression level was found. CONCLUSIONS This study describes a specific pattern of the Casp-1 system associated with inflammation and apoptosis markers in patients who require LVAD insertion. The inflammation could be the key process regulating, in a negative loop, Casp-1 signaling and its down-stream effects, apoptosis included.
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Affiliation(s)
- Tommaso Prescimone
- CNR Institute of Clinical Physiology, Laboratory of Cardiovascular Biochemistry, Pisa, Italy
| | | | - Chiara Caselli
- CNR Institute of Clinical Physiology, Laboratory of Cardiovascular Biochemistry, Pisa, Italy
| | - Manuela Cabiati
- CNR Institute of Clinical Physiology, Laboratory of Cardiovascular Biochemistry, Pisa, Italy
| | - Federica Viglione
- CNR Institute of Clinical Physiology, Laboratory of Cardiovascular Biochemistry, Pisa, Italy
| | - Raffaele Caruso
- CNR Institute of Clinical Physiology, Cardiovascular Department, Niguarda Cà Granda Hospital, Milan, Italy
| | - Alessandro Verde
- CardioThoracic and Vascular Department, "A. De Gasperis" Niguarda Ca' Granda Hospital, Milan, Italy
| | - Silvia Del Ry
- CNR Institute of Clinical Physiology, Laboratory of Cardiovascular Biochemistry, Pisa, Italy
| | - Maria Giovanna Trivella
- CNR Institute of Clinical Physiology, Laboratory of Cardiovascular Biochemistry, Pisa, Italy
| | - Daniela Giannessi
- CNR Institute of Clinical Physiology, Laboratory of Cardiovascular Biochemistry, Pisa, Italy.
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Apoptotic transcriptional profile remains activated in late remodeled left ventricle after myocardial infarction in swine infarcted hearts with preserved ejection fraction. Pharmacol Res 2013; 70:41-9. [DOI: 10.1016/j.phrs.2012.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 11/28/2012] [Accepted: 12/04/2012] [Indexed: 12/31/2022]
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Del Ry S, Cabiati M, Lionetti V, Aquaro GD, Martino A, Mattii L, Morales MA. Pacing-induced regional differences in adenosine receptors mRNA expression in a swine model of dilated cardiomyopathy. PLoS One 2012; 7:e47011. [PMID: 23071699 PMCID: PMC3470544 DOI: 10.1371/journal.pone.0047011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 09/11/2012] [Indexed: 01/09/2023] Open
Abstract
The adenosinergic system is essential in the mediation of intrinsic protection and myocardial resistance to insult; it may be considered a cardioprotective molecule and adenosine receptors (ARs) represent potential therapeutic targets in the setting of heart failure (HF). The aim of the study was to test whether differences exist between mRNA expression of ARs in the anterior left ventricle (LV) wall (pacing site: PS) compared to the infero septal wall (opposite region: OS) in an experimental model of dilated cardiomyopathy. Cardiac tissue was collected from LV PS and OS of adult male minipigs with pacing-induced HF (n = 10) and from a control group (C, n = 4). ARs and TNF–α mRNA expression was measured by Real Time-PCR and the results were normalized with the three most stably expressed genes (GAPDH, HPRT1, TBP). Immunohistochemistry analysis was also performed. After 3 weeks of pacing higher levels of expression for each analyzed AR were observed in PS except for A1R (A1R: C = 0.6±0.2, PS = 0.1±0.04, OS = 0.04±0.01, p<0.0001 C vs. PS and OS respectively; A2AR: C = 1.04±0.59, PS = 2.62±0.79, OS = 2.99±0.79; A2BR: C = 1.2±0.1, PS = 5.59±2.3, OS = 1.59±0.46; A3R: C = 0.76±0.18, PS = 8.40±3.38, OS = 4.40±0.83). Significant contractile impairment and myocardial hypoperfusion were observed at PS after three weeks of pacing as compared to OS. TNF-α mRNA expression resulted similar in PS (6.3±2.4) and in OS (5.9±2.7) although higher than in control group (3.4±1.5). ARs expression was mainly detected in cardiomyocytes. This study provided new information on ARs local changes in the setting of LV dysfunction and on the role of these receptors in relation to pacing-induced abnormalities of myocardial perfusion and contraction. These results suggest a possible therapeutic role of adenosine in patients with HF and dyssynchronous LV contraction.
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MESH Headings
- Animals
- Cardiac Pacing, Artificial
- Cardiomyopathy, Dilated/genetics
- Cardiomyopathy, Dilated/physiopathology
- Cardiomyopathy, Dilated/therapy
- Disease Models, Animal
- Gene Expression Regulation
- Heart Failure/genetics
- Heart Failure/physiopathology
- Heart Rate/genetics
- Heart Ventricles/physiopathology
- Magnetic Resonance Imaging
- Male
- RNA, Messenger
- Receptors, Purinergic P1/genetics
- Receptors, Purinergic P1/metabolism
- Swine
- Swine, Miniature
- Tumor Necrosis Factor-alpha/genetics
- Ventricular Dysfunction, Left/physiopathology
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Klug D, Boule S, Wissocque L, Montaigne D, Marechal X, Hassoun SM, Neviere R. Right ventricular pacing with mechanical dyssynchrony causes apoptosis interruptus and calcium mishandling. Can J Cardiol 2012; 29:510-8. [PMID: 23062666 DOI: 10.1016/j.cjca.2012.08.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 08/03/2012] [Accepted: 08/03/2012] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Mechanical dyssynchrony associated with rapid pacing induces cardiac cell stress and myocardial apoptotic pathway activation that has been implicated in the pathophysiology of left ventricular (LV) dysfunction. Effects of dyssynchrony per se are not fully understood. The objective of our study was to test whether ventricular dyssynchrony would elicit myocardial alterations in LV calcium handling regulation and cell survival or apoptosis signalling in right ventricular-paced swine. METHODS Implantation of pacemaker was performed under anaesthesia. Endocardial bipolar screw lead was inserted into the right jugular vein and positioned either in the right atrium or at the right ventricular (RV) apex. Swine were paced at 150 beats per minute for 3 weeks. RESULTS Compared with right atrial pacing, RV pacing led to abnormal LV sarcoplasmic reticulum calcium uptake (315 ± 65 vs 155 ± 55 nmol/min/mg, P < 0.05) and LV calcium-handling protein expression, ie, 35% reduction in ryanodine receptor 2, 25% decline in sarcoplasmic reticulum Ca(2+) ATPase, 70% increase in Na(+)/Ca(2+) exchanger, and 10% increase in phospholamban. RV pacing also elicited activation of LV apoptotic cascades without nuclear apoptosis. So-called interrupted apoptosis was the result of increased expression of X-linked inhibitor of apoptosis protein. Apoptosis and calcium mishandling were documented in absence of depressed heart function (ejection fraction 62 ± 8% vs 57 ± 12%, in right atrial- and RV-paced hearts, respectively, P > 0.05). CONCLUSIONS Slow rate RV pacing causes mechanical dyssynchrony and profound LV alterations in both apoptotic pathways and calcium handling in the early stages of pacing-induced cardiomyopathy.
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Affiliation(s)
- Didier Klug
- EA 4484, Département de Physiologie, Université Lille 2, Faculté de Médecine de Lille, Lille, France
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Giannessi D. Multimarker approach for heart failure management: Perspectives and limitations. Pharmacol Res 2011; 64:11-24. [DOI: 10.1016/j.phrs.2011.03.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Revised: 03/10/2011] [Accepted: 03/20/2011] [Indexed: 12/29/2022]
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