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Hu D, Li R, Li Y, Wang M, Wang L, Wang S, Cheng H, Zhang Q, Fu C, Qian Z, Wei Q. Inflammation-Targeted Nanomedicines Alleviate Oxidative Stress and Reprogram Macrophages Polarization for Myocardial Infarction Treatment. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2308910. [PMID: 38582507 DOI: 10.1002/advs.202308910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/27/2024] [Indexed: 04/08/2024]
Abstract
Myocardial infarction (MI) is a critical global health challenge, with current treatments limited by the complex MI microenvironment, particularly the excessive oxidative stress and intense inflammatory responses that exacerbate cardiac dysfunction and MI progression. Herein, a mannan-based nanomedicine, Que@MOF/Man, is developed to target the inflammatory infarcted heart and deliver the antioxidative and anti-inflammatory agent quercetin (Que), thereby facilitating a beneficial myocardial microenvironment for cardiac repair. The presence of mannan on the nanoparticle surface enables selective internalization by macrophages rather than cardiomyocytes. Que@MOF/Man effectively neutralizes reactive oxygen species in macrophages to reduce oxidative stress and promote their differentiation into a reparative phenotype, reconciling the inflammatory response and enhancing cardiomyocyte survival through intercellular communication. Owing to the recruitment of macrophages into inflamed myocardium post-MI, in vivo, administration of Que@MOF/Man in MI rats revealed the specific distribution into the injured myocardium compared to free Que. Furthermore, Que@MOF/Man exhibited favorable results in resolving inflammation and protecting cardiomyocytes, thereby preventing further myocardial remodeling and improving cardiac function in MI rats. These findings collectively validate the rational design of an inflammation-targeted delivery strategy to mitigate oxidative stress and modulate the inflammation response in the injured heart, presenting a therapeutic avenue for MI treatment.
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Affiliation(s)
- Danrong Hu
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, Key Laboratory of Rehabilitation Medicine in Sichuan Province, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Collaborative Innovation Center, Sichuan University, Chengdu, Sichuan, 610041, P. R. China
| | - Ran Li
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, Key Laboratory of Rehabilitation Medicine in Sichuan Province, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Collaborative Innovation Center, Sichuan University, Chengdu, Sichuan, 610041, P. R. China
| | - Yicong Li
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, Key Laboratory of Rehabilitation Medicine in Sichuan Province, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Collaborative Innovation Center, Sichuan University, Chengdu, Sichuan, 610041, P. R. China
| | - Meng Wang
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, Key Laboratory of Rehabilitation Medicine in Sichuan Province, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Collaborative Innovation Center, Sichuan University, Chengdu, Sichuan, 610041, P. R. China
| | - Lu Wang
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, Key Laboratory of Rehabilitation Medicine in Sichuan Province, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Collaborative Innovation Center, Sichuan University, Chengdu, Sichuan, 610041, P. R. China
| | - Shiqi Wang
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, Key Laboratory of Rehabilitation Medicine in Sichuan Province, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Collaborative Innovation Center, Sichuan University, Chengdu, Sichuan, 610041, P. R. China
| | - Hongxin Cheng
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, Key Laboratory of Rehabilitation Medicine in Sichuan Province, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Collaborative Innovation Center, Sichuan University, Chengdu, Sichuan, 610041, P. R. China
| | - Qing Zhang
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, Key Laboratory of Rehabilitation Medicine in Sichuan Province, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Collaborative Innovation Center, Sichuan University, Chengdu, Sichuan, 610041, P. R. China
| | - Chenying Fu
- National Clinical Research Center for Geriatrics, Aging and Geriatric Mechanism Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China
| | - Zhiyong Qian
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, Key Laboratory of Rehabilitation Medicine in Sichuan Province, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Collaborative Innovation Center, Sichuan University, Chengdu, Sichuan, 610041, P. R. China
| | - Quan Wei
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, Key Laboratory of Rehabilitation Medicine in Sichuan Province, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Collaborative Innovation Center, Sichuan University, Chengdu, Sichuan, 610041, P. R. China
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Pec J, Buchner S, Fox H, Oldenburg O, Stadler S, Maier LS, Arzt M, Wagner S. Inflammation and Fibrosis in Sleep-Disordered Breathing after Acute Myocardial Infarction. Biomedicines 2024; 12:154. [PMID: 38255259 PMCID: PMC10813793 DOI: 10.3390/biomedicines12010154] [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: 11/30/2023] [Revised: 12/13/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND After acute myocardial infarction (AMI), inflammatory processes promote tissue remodeling at the infarct site. Procollagen III amino-terminal propeptide (PIIINP) is a circulating biomarker of type III collagen synthesis that has been shown to be associated with changes in left ventricular ejection fraction (LVEF) and predicts the occurrence of heart failure after AMI. We hypothesize that sleep-disordered breathing (SDB) promotes inflammation and myocardial fibrosis, leading to reduced myocardial salvage. Therefore, in patients with first-time AMI successfully treated with percutaneous coronary intervention (PCI), we aimed to investigate whether circulating levels of high-sensitivity C-reactive protein (hs-CRP) and PIIINP are elevated in patients with SDB compared to patients without SDB. METHODS AND RESULTS This cross-sectional analysis included a total of 88 eligible patients with first AMI and PCI pooled from two prospective studies and stratified according to the apnea-hypopnea index (AHI, with SDB: AHI ≥ 15 h-1). We analyzed circulating levels of hs-CRP and PIIINP 3-5 days after PCI. Patients with SDB had significantly higher levels of hs-CRP (18.3 mg/L [95% CI, 8.0-42.6] vs. 5.8 mg/L [95% CI, 4.2-19.8], p = 0.002) and PIIINP (0.49 U/mL [95% CI, 0.40-0.60] vs. 0.33 U/mL [95% CI, 0.28-0.43], p < 0.001). In a multivariable linear regression model accounting for important clinical confounders, SDB significantly predicted circulating levels of hs-CRP (p = 0.028). Similarly, only SDB was independently associated with PIIINP (p < 0.001). Only obstructive but not central AHI correlated with circulating levels of hs-CRP (p = 0.012) and PIIINP (p = 0.006) levels. CONCLUSIONS The presence of obstructive SDB after AMI was independently associated with increased circulating levels of hs-CRP and PIIINP. Our results emphasize the important role of SDB as a common comorbidity and indicate increased inflammation and myocardial fibrosis in these patients.
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Affiliation(s)
- Jan Pec
- Department of Internal Medicine II, University Hospital Regensburg, 93053 Regensburg, Germany (L.S.M.); (M.A.); (S.W.)
| | - Stefan Buchner
- Department of Internal Medicine, Cham Hospital, 93413 Cham, Germany
| | - Henrik Fox
- Clinic for General and Interventional Cardiology/Angiology, Heart and Diabetes Center NRW, Ruhr University Bochum, 32545 Bad Oeynhausen, Germany
| | - Olaf Oldenburg
- Center for Cardiology, Ludgerus-Kliniken, 48153 Münster, Germany;
| | - Stefan Stadler
- Department of Internal Medicine II, University Hospital Regensburg, 93053 Regensburg, Germany (L.S.M.); (M.A.); (S.W.)
| | - Lars S. Maier
- Department of Internal Medicine II, University Hospital Regensburg, 93053 Regensburg, Germany (L.S.M.); (M.A.); (S.W.)
| | - Michael Arzt
- Department of Internal Medicine II, University Hospital Regensburg, 93053 Regensburg, Germany (L.S.M.); (M.A.); (S.W.)
| | - Stefan Wagner
- Department of Internal Medicine II, University Hospital Regensburg, 93053 Regensburg, Germany (L.S.M.); (M.A.); (S.W.)
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