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Siani A, Proaspatu M, Lanzo G, Irico P, Rodolfi S, Carriero S, Guglielmo M. Petrified heart in a patient with Wolfram Syndrome. J Public Health Res 2022; 11:22799036221107063. [PMID: 35911432 PMCID: PMC9335481 DOI: 10.1177/22799036221107063] [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] [Received: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 11/20/2022] Open
Abstract
Myocardial calcification is a rare complication of severe systemic sepsis. The pathophysiological mechanisms underlying calcium accumulation in cardiomyocytes in generalized sepsis are complex and still under investigation. It is a serious and life-threatening condition, usually diagnosed by autopsy, rarely with imaging techniques. We describe the case of a 38-year-old woman with Wolfram Syndrome who developed diffuse myocardial calcification during an episode of generalized sepsis.
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Affiliation(s)
- Agnese Siani
- Radiology Department, Ospedale Maggiore della Carità University Hospital, Novara, Italy
| | - Mirela Proaspatu
- Radiology Department, Ospedale Maggiore della Carità University Hospital, Novara, Italy
| | - Giuseppe Lanzo
- Radiology Department, Ospedale Maggiore della Carità University Hospital, Novara, Italy
| | - Paolo Irico
- Radiology Department, Ospedale Maggiore della Carità University Hospital, Novara, Italy
| | - Sara Rodolfi
- Radiology Department, Ospedale Maggiore della Carità University Hospital, Novara, Italy
| | - Serena Carriero
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Marco Guglielmo
- Radiology Department, Ospedale Maggiore della Carità University Hospital, Novara, Italy
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2
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Xie S, Qi X, Wu Q, Wei L, Zhang M, Xing Y, Shi W, Chen S, Zeng X, Wang S, Guo H, Deng W. Inhibition of 5-lipoxygenase is associated with downregulation of the leukotriene B4 receptor 1/ Interleukin-12p35 pathway and ameliorates sepsis-induced myocardial injury. Free Radic Biol Med 2021; 166:348-357. [PMID: 33705958 DOI: 10.1016/j.freeradbiomed.2021.02.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/19/2021] [Accepted: 02/24/2021] [Indexed: 11/21/2022]
Abstract
Sepsis rapidly contributed to multiorgan failure affecting most commonly of the cardiovascular and respiratory systems and yet there were no effective therapies. The current study aimed at providing evidence on the cardioprotection of suppression of 5-Lipoxygenase (5-Lox) and identifying the possible mechanism in the mouse model of sepsis. The cecal ligation-perforation (CLP) model was applied to C57BL/6 wild-type (WT) and 5-Lox deficient (5-Lox-/-) mice to induce sepsis. 5-Lox expression was up-regulated in mouse myocardium and leukotriene B4 (LTB4) level was increased in serum after sepsis. Subsequently, we utilized a recombinant adenoviral expression vector (rAAV9) to overexpress Alox5 gene in adult mice. Compared to WT mice, 5-Lox overexpression accelerated CLP-induced myocardial injury and cardiac dysfunction. Oppositely, 5-Lox deficiency offered protection against myocardial injury in a mouse model of sepsis and attenuated sepsis-mediated inflammation, oxidative stress and apoptosis in the mouse heart. Mechanically, 5-Lox promoted LTB4 production, which in turn contributed to the activation of leukotriene B4 receptor 1 (BLT1)/interleukin-12p35 (IL-12p35) pathway and enhanced M1 macrophage polarization. However, the suppression of BLT1 by either gene mutation or antagonist U75302 significantly inhibited the adverse effect of 5-Lox in sepsis. Further study demonstrated that pharmacological inhibition of 5-Lox prevented CLP-induced septic cardiomyopathy (SCM). Our study identified 5-Lox exacerbated sepsis-associated myocardial injury through activation of LTB4 production and promoting BLT1/IL-12p35 pathway. Hence, inhibition of 5-Lox may be a potential candidate strategy for septic cardiac dysfunction treatment.
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Affiliation(s)
- Saiyang Xie
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China; Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, China
| | - Xiping Qi
- Department of Transfusion, Wuhan Hospital of Traditional Chinese and Western Medicine (Wuhan No.1 Hospital), Wuhan, 430060, China
| | - Qingqing Wu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China; Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, China
| | - Li Wei
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Min Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China; Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, China
| | - Yun Xing
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China; Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, China
| | - Wenke Shi
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China; Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, China
| | - Si Chen
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China; Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, China
| | - Xiaofeng Zeng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China; Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, China
| | - Shasha Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China; Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, China
| | - Haipeng Guo
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital of Shandong University, Jinan, 250012, China; Department of Critical Care Medicine, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, 250012, China
| | - Wei Deng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China; Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, China.
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Cappelletti S, Piacentino D, Ciallella C. A systematic review of radiological and histological findings of septic myocardial calcifications. J Forensic Leg Med 2020; 74:102026. [PMID: 32755766 DOI: 10.1016/j.jflm.2020.102026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/08/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022]
Abstract
Myocardial calcification is a life-threatening condition that is a recognised complication of ischaemic heart disease, cardiac surgery, rheumatic fever, myocarditis and sepsis. Only sparse data, reporting the clinical symptoms, the anatomo-pathological findings, the imaging findings have been published and no exhaustive analysis of all these factors exists in literature. To date, there have been 26 published cases in the medical literature in which myocardial calcifications is the consequence of a septic status. In this review, we will describe the main imaging and histological findings, with particular attention to the known and hypothesized mechanisms of myocardial calcifications. The results of this study may help clinicians and forensic pathologists to identify possible unrecognized cases and inspire the development of an international registry by which to coordinate further research.
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Affiliation(s)
- Simone Cappelletti
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy; State Police Health Service Department, Ministry of Interior, Rome, Italy.
| | - Daria Piacentino
- Department of Psychiatry, Central Hospital, Sanitary Agency of South Tyrol, Bolzano-Bozen, Italy
| | - Costantino Ciallella
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
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4
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Bower G, Ashrafian H, Cappelletti S, Lee LM, Harling L, Ciallella C, Aromatario M, Athanasiou T. A proposed role for sepsis in the pathogenesis of myocardial calcification. Acta Cardiol 2017. [PMID: 28636521 DOI: 10.1080/00015385.2017.1305163] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Guy Bower
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Hutan Ashrafian
- Department of Surgery and Cancer, Imperial College London, London, UK
- Department of Cardiothoracic Surgery, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Simone Cappelletti
- Department of Surgery and Cancer, Imperial College London, London, UK
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Liang Mei Lee
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Leanne Harling
- Department of Surgery and Cancer, Imperial College London, London, UK
- Department of Cardiothoracic Surgery, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Costantino Ciallella
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Mariarosaria Aromatario
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Thanos Athanasiou
- Department of Surgery and Cancer, Imperial College London, London, UK
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5
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Ashton KJ, Reichelt ME, Mustafa SJ, Teng B, Ledent C, Delbridge LMD, Hofmann PA, Morrison RR, Headrick JP. Transcriptomic effects of adenosine 2A receptor deletion in healthy and endotoxemic murine myocardium. Purinergic Signal 2016; 13:27-49. [PMID: 27696085 DOI: 10.1007/s11302-016-9536-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 09/09/2016] [Indexed: 12/25/2022] Open
Abstract
Influences of adenosine 2A receptor (A2AR) activity on the cardiac transcriptome and genesis of endotoxemic myocarditis are unclear. We applied transcriptomic profiling (39 K Affymetrix arrays) to identify A2AR-sensitive molecules, revealed by receptor knockout (KO), in healthy and endotoxemic hearts. Baseline cardiac function was unaltered and only 37 A2AR-sensitive genes modified by A2AR KO (≥1.2-fold change, <5 % FDR); the five most induced are Mtr, Ppbp, Chac1, Ctsk and Cnpy2 and the five most repressed are Hp, Yipf4, Acta1, Cidec and Map3k2. Few canonical paths were impacted, with altered Gnb1, Prkar2b, Pde3b and Map3k2 (among others) implicating modified G protein/cAMP/PKA and cGMP/NOS signalling. Lipopolysaccharide (LPS; 20 mg/kg) challenge for 24 h modified >4100 transcripts in wild-type (WT) myocardium (≥1.5-fold change, FDR < 1 %); the most induced are Lcn2 (+590); Saa3 (+516); Serpina3n (+122); Cxcl9 (+101) and Cxcl1 (+89) and the most repressed are Car3 (-38); Adipoq (-17); Atgrl1/Aplnr (-14); H19 (-11) and Itga8 (-8). Canonical responses centred on inflammation, immunity, cell death and remodelling, with pronounced amplification of toll-like receptor (TLR) and underlying JAK-STAT, NFκB and MAPK pathways, and a 'cardio-depressant' profile encompassing suppressed ß-adrenergic, PKA and Ca2+ signalling, electromechanical and mitochondrial function (and major shifts in transcripts impacting function/injury including Lcn2, S100a8/S100a9, Icam1/Vcam and Nox2 induction, and Adipoq, Igf1 and Aplnr repression). Endotoxemic responses were selectively modified by A2AR KO, supporting inflammatory suppression via A2AR sensitive shifts in regulators of NFκB and JAK-STAT signalling (IκBζ, IκBα, STAT1, CDKN1a and RRAS2) without impacting the cardio-depressant gene profile. Data indicate A2ARs exert minor effects in un-stressed myocardium and selectively suppress NFκB and JAK-STAT signalling and cardiac injury without influencing cardiac depression in endotoxemia.
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Affiliation(s)
- Kevin J Ashton
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Melissa E Reichelt
- School of Biomedical Sciences, University of Queensland, Brisbane, QLD, Australia
| | - S Jamal Mustafa
- Department of Physiology and Pharmacology, West Virginia University, Morgantown, WV, USA
| | - Bunyen Teng
- Department of Physiology and Pharmacology, West Virginia University, Morgantown, WV, USA
| | | | - Lea M D Delbridge
- Department of Physiology, University of Melbourne, Parkville, VIC, Australia
| | - Polly A Hofmann
- Department of Physiology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - R Ray Morrison
- Division of Critical Care Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - John P Headrick
- Heart Foundation Research Center, Griffith University, Southport, QLD, 4217, Australia.
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Mastronardi CA, Paz-Filho G, Zanoni M, Molano-González N, Arcos-Burgos M, Licinio J, Wong ML. Temporal gene expression in the hippocampus and peripheral organs to endotoxin-induced systemic inflammatory response in caspase-1-deficient mice. Neuroimmunomodulation 2015; 22:263-73. [PMID: 25633245 PMCID: PMC4710542 DOI: 10.1159/000368310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 09/05/2014] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES Caspase-1 (casp1), a key protease involved in the systemic inflammatory response syndrome (SIRS), controls the brain expression of a set of eight genes: Nos2 and Ptgs2 (nitric oxide synthase 2 and prostaglandin-endoperoxide synthase 2, two inducible enzymes), Cxcl1 and Cxcl10 (C-X-C motif chemokine ligand 1 and ligand 10), Tgtp and Gbp2 (T cell-specific GTPase 1 and guanylate-binding protein 2, two GTPases), Adamts1 (a disintegrin-like and metallopeptidase with thrombospondin type 1 motif, 1, a metalloprotease) and Il1rn (interleukin-1 receptor antagonist). Our objective was to ascertain whether casp1 also controlled the peripheral expression of these genes and, if so, to compare their central versus peripheral patterns of gene expression in immune and endocrine tissues during SIRS. METHODS Wild-type (wt) and casp1 knockout (casp1(-/-)) mice were injected with either saline or a high dose of endotoxin/lipopolysaccharide (LPS; 800 μg/mice i.p.). Saline-injected mice were immediately euthanized after injection, whereas LPS-injected mice were sacrificed 6 and 12 h after LPS administration. Hippocampal, splenic and adrenal gene expressions were determined by real-time PCR. RESULTS Overall, casp1(-/-) mice showed a lower inflammatory response than wt mice. The expression levels of powerful proinflammatory factors such as Nos2 and Ptgs2 was reduced in casp1(-/-) mice. Moreover, a hierarchical clustering analysis aimed at studying patterns of gene coexpression revealed large alterations in the hippocampal pattern of casp1(-/-) mice. Surprisingly, the expression of Adamts1 was increased in the hippocampus and adrenals of casp1(-/-) mice. CONCLUSIONS The resilience of casp1(-/-) mice to SIRS lethality is associated with a lower inflammatory response, loss of hippocampal gene coexpression patterns, and increased hippocampal Adamts1 gene expression. The latter might be beneficial for casp1(-/-) mice, since ADAMTS1 is likely to play a role in neuronal plasticity. The mechanisms described here may help the development of either novel biomarkers or therapeutic targets against SIRS/sepsis.
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Affiliation(s)
- Claudio Alberto Mastronardi
- Genomics and Predictive Medicine Group, Genome Biology Department, John Curtin School of Medical Research, Australian National University, Canberra, Australia
| | - Gilberto Paz-Filho
- Genomics and Predictive Medicine Group, Genome Biology Department, John Curtin School of Medical Research, Australian National University, Canberra, Australia
| | - Martina Zanoni
- Department of Psychiatry, University of Verona, Verona, Italy
| | - Nicolas Molano-González
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Mauricio Arcos-Burgos
- Genomics and Predictive Medicine Group, Genome Biology Department, John Curtin School of Medical Research, Australian National University, Canberra, Australia
| | - Julio Licinio
- Mind and Brain Theme, South Australian Health and Medical Research Institute and Flinders University of South Australia, Adelaide, Australia
| | - Ma-Li Wong
- Mind and Brain Theme, South Australian Health and Medical Research Institute and Flinders University of South Australia, Adelaide, Australia
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Lee KCL, Palacios Jimenez C, Alibhai H, Chang YM, Leckie PJ, Baker LA, Stanzani G, L Priestnall S, Mookerjee RP, Jalan R, Davies NA. A reproducible, clinically relevant, intensively managed, pig model of acute liver failure for testing of therapies aimed to prolong survival. Liver Int 2013; 33:544-51. [PMID: 23331547 DOI: 10.1111/liv.12042] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Accepted: 11/01/2012] [Indexed: 12/14/2022]
Abstract
BACKGROUND A clinically relevant, translational large animal model of acute liver failure (ALF) is required for testing of novel therapies to prolong survival in acute liver failure, to permit spontaneous liver recovery or to act as a bridge to transplantation. AIMS The aim was to establish a pig model of acetaminophen-induced ALF that mimics the human clinical syndrome, is managed as in a human intensive care unit and has a predictable survival time. METHODS Nine female pigs were anaesthetised and instrumented for continuous intensive care monitoring and management using: target-driven protocols for treatment of cardiovascular collapse, metabolic acidosis and electrolyte abnormalities; intermittent positive pressure ventilation; and continuous renal replacement therapy. Six animals were induced to ALF with acetaminophen (paracetamol). Three animals acted as controls. RESULTS Irreversible acute liver failure, defined as rise in prothrombin time >3 times normal, occurred 19.3 ± 1.8 h after the onset of acetaminophen administration. Death occurred predictably 12.6 ± 2.7 h thereafter, with acute hepatocellular necrosis in all animals. Clinical progression of liver failure mimicked the human condition including development of coagulopathy, intracranial hypertension, hyperammonaemia, cardiovascular collapse, elevation in creatinine, metabolic acidosis and hyperlactataemia. In addition, cardiovascular monitoring clearly demonstrated progressive cardiac dysfunction in ALF. CONCLUSIONS A reproducible, clinically relevant, intensively managed, large animal model of acute liver failure, with death as a result of multi-organ failure, has been successfully validated for translational studies of disease progression and therapies designed to prolong survival in man.
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Affiliation(s)
- Karla C L Lee
- Department of Veterinary Clinical Sciences, Royal Veterinary College, University of London, UK.
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Yang IV, Alper S, Lackford B, Rutledge H, Warg LA, Burch LH, Schwartz DA. Novel regulators of the systemic response to lipopolysaccharide. Am J Respir Cell Mol Biol 2010; 45:393-402. [PMID: 21131441 DOI: 10.1165/rcmb.2010-0342oc] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Our understanding of the role that host genetic factors play in the initiation and severity of infections caused by gram-negative bacteria is incomplete. To identify novel regulators of the host response to lipopolysaccharide (LPS), 11 inbred murine strains were challenged with LPS systemically. In addition to two strains lacking functional TLR4 (C3H/HeJ and C57BL/6J(TLR4-/-)), three murine strains with functional TLR4 (C57BL/6J, 129/SvImJ, and NZW/LacJ) were found to be relatively resistant to systemic LPS challenge; the other six strains were classified as sensitive. RNA from lung, liver, and spleen tissue was profiled on oligonucleotide microarrays to determine if unique transcripts differentiate susceptible and resistant strains. Gene expression analysis identified the Hedgehog signaling pathway and a number of transcription factors (TFs) involved in the response to LPS. RNA interference-mediated inhibition of six TFs (C/EBP, Cdx-2, E2F1, Hoxa4, Nhlh1, and Tead2) was found to diminish IL-6 and TNF-α production by murine macrophages. Mouse lines with targeted mutations were used to verify the involvement of two novel genes in innate immunity. Compared with wild-type control mice, mice deficient in the E2F1 transcription factor were found to have a reduced inflammatory response to systemic LPS, and mice heterozygote for Ptch, a gene involved in Hedgehog signaling, were found to be more responsive to systemic LPS. Our analysis of gene expression data identified novel pathways and transcription factors that regulate the host response to systemic LPS. Our results provide potential sepsis biomarkers and therapeutic targets that should be further investigated in human populations.
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Affiliation(s)
- Ivana V Yang
- Center for Genes, Environment and Health, National Jewish Health, Denver, CO 80206, USA.
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9
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Chen TC, Lu PL, Lin CY, Lin WR, Chen YH. Escherichia coli urosepsis complicated with myocarditis mimicking acute myocardial infarction. Am J Med Sci 2010; 340:332-4. [PMID: 20601856 DOI: 10.1097/maj.0b013e3181e92e71] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Myocarditis is defined clinically as inflammation of the heart muscle, which can be caused by infectious agents, toxins or immunologic reactions. Most recognized cases of acute myocarditis are secondary to cardiotropic viral infections. Escherichia coli rarely cause myocarditis. The authors report a 25-year-old woman with E coli-induced acute pyelonephritis and septic shock that was complicated with acute myocarditis. Her symptoms mimicked acute myocardial infarction. The authors discuss the possible mechanism of bacterial sepsis-induced myocarditis.
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Affiliation(s)
- Tun-Chieh Chen
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung City, Taiwan
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10
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Watanabe R, Hanawa H, Yoshida T, Ito M, Isoda M, Chang H, Toba K, Yoshida K, Kojima M, Otaki K, Ding L, Hao K, Kato K, Kodama M, Aizawa Y. Gene expression profiles of cardiomyocytes in rat autoimmune myocarditis by DNA microarray and increase of regenerating gene family. Transl Res 2008; 152:119-27. [PMID: 18774541 DOI: 10.1016/j.trsl.2008.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2008] [Revised: 07/13/2008] [Accepted: 07/17/2008] [Indexed: 10/21/2022]
Abstract
Cardiomyocytes with myocarditis compared with the normal state are thought to change the expressions of various genes greatly, some of which may be new biomarkers or new biologic medicinal products. However, until now, little comprehensive analysis has been made of gene-expression changes in cardiomyocytes with myocarditis. In this study, we performed a DNA microarray analysis by using cardiomyocytes from rat experimental autoimmune myocarditis (EAM). On day 0, rats were immunized with porcine cardiac myosin and cardiomyocytes were isolated and purified from EAM hearts and normal hearts by a method that is hardly thought to change gene expressions in cardiomyocytes. RNA from normal cardiomyocytes and cardiomyocytes of EAM on day 18 was analyzed for 7711 gene expressions by DNA microarray. Some gene expressions showed over 10-fold changes. In particular, the regenerated gene (Reg)2/pancreatitis-associated protein (PAP)1 messenger RNA (mRNA) level most markedly increased in the genes, which were clearly expressed in cardiomyocytes rather than in noncardiomyocytes, and it was approximately 2000-fold greater in cardiomyocytes under active myocarditis than normal by real-time reverse transcription polymerase chain reaction analysis. Moreover, we demonstrated that Reg2/PAP1 proteins determined by Western blot analysis and immunohistochemistry and other Reg/PAP family gene expressions were remarkably increased in EAM hearts; in addition, interleukin (IL)-6 expression was significantly related to Reg2/PAP1. It seemed that these data were useful as a reference database of gene-expression changes in cardiomyocytes with myocarditis. The Reg/PAP family, which was found to show dramatically increasing gene expressions by DNA microarray analysis, was suspected to play an important role in myocarditis.
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Affiliation(s)
- Ritsuo Watanabe
- Division of Cardiology, Department of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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11
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Diniz PPVP, de Morais HSA, Breitschwerdt EB, Schwartz DS. Serum cardiac troponin I concentration in dogs with ehrlichiosis. J Vet Intern Med 2008; 22:1136-43. [PMID: 18638021 DOI: 10.1111/j.1939-1676.2008.0145.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Ehrlichiosis is a multisystemic disease with the potential to cause cardiomyocyte injury in naturally infected dogs. HYPOTHESIS Myocardial injury occurs in dogs infected with Ehrlichia canis. ANIMALS One-hundred and ninety-four dogs from Brazil with clinical and laboratory abnormalities indicative of ehrlichiosis. Sixteen healthy dogs served as controls. METHODS Electrocardiogram, echocardiogram, noninvasive blood pressure measurement, and serum cardiac troponin I (cTnI) concentrations were evaluated. Serologic assays and PCR determined the exposure and infection status for E. canis, Anaplasma spp., Babesia canis vogeli, Bartonella spp., Borrelia burgdorferi, Dirofilaria immitis, Ehrlichia chaffeensis, Ehrlichia ewingii, Leishmania chagasi, and spotted-fever group Rickettsia. Dogs were assigned to groups according to PCR status: E. canis infected, infected with other vector-borne organisms, sick dogs lacking PCR evidence for infection, and healthy controls. RESULTS E. canis-infected dogs had higher serum cTnI concentrations than controls (median: 0.04 ng/dL; range 0.04-9.12 ng/dL; control median: 0.04 ng/dL; range: 0.04-0.10 ng/dL; P= .012), and acute E. canis infection was associated with myocardial injury (odds ratio [OR]: 2.67, confidence interval [CI] 95%: 1.12-6.40, P= .027). Severity of anemia was correlated with increased risk of cardiomyocyte damage (r= 0.84, P< .001). Dogs with clinical signs of systemic inflammatory response syndrome (SIRS) were at higher risk for myocardial injury than were other sick dogs (OR: 2.55, CI 95%: 1.31-4.95, P= .005). CONCLUSIONS AND CLINICAL IMPORTANCE Acute infection with E. canis is a risk factor for myocardial injury in naturally infected Brazilian dogs. Severity of anemia and SIRS might contribute to the pathophysiology of myocardial damage.
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Affiliation(s)
- P P V P Diniz
- Intracellular Pathogens Research Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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12
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Jenwitheesuk E, Horst JA, Rivas KL, Van Voorhis WC, Samudrala R. Novel paradigms for drug discovery: computational multitarget screening. Trends Pharmacol Sci 2008; 29:62-71. [PMID: 18190973 PMCID: PMC4551513 DOI: 10.1016/j.tips.2007.11.007] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2007] [Revised: 11/16/2007] [Accepted: 11/16/2007] [Indexed: 12/24/2022]
Abstract
An established paradigm in current drug development is (i) to identify a single protein target whose inhibition is likely to result in the successful treatment of a disease of interest; (ii) to assay experimentally large libraries of small-molecule compounds in vitro and in vivo to identify promising inhibitors in model systems; and (iii) to determine whether the findings are extensible to humans. This complex process, which is largely based on trial and error, is risk-, time- and cost-intensive. Computational (virtual) screening of drug-like compounds simultaneously against the atomic structures of multiple protein targets, taking into account protein-inhibitor dynamics, might help to identify lead inhibitors more efficiently, particularly for complex drug-resistant diseases. Here we discuss the potential benefits of this approach, using HIV-1 and Plasmodium falciparum infections as examples. We propose a virtual drug discovery 'pipeline' that will not only identify lead inhibitors efficiently, but also help minimize side-effects and toxicity, thereby increasing the likelihood of successful therapies.
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Affiliation(s)
- Ekachai Jenwitheesuk
- Department of Microbiology, School of Medicine, University of Washington, Box 357242, Seattle, WA 98195, USA
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Cuenca J, Goren N, Prieto P, Martín-Sanz P, Boscá L. Selective impairment of nuclear factor-kappaB-dependent gene transcription in adult cardiomyocytes: relevance for the regulation of the inflammatory response in the heart. THE AMERICAN JOURNAL OF PATHOLOGY 2007; 171:820-8. [PMID: 17675583 PMCID: PMC1959507 DOI: 10.2353/ajpath.2007.061076] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The ability of neonatal and adult cardiomyocytes to activate the nuclear factor (NF)-kappaB pathway in response to lipopolysaccharide and interleukin-1beta challenge has been investigated and compared with that of peritoneal macrophages. The activation of the IkappaB kinase and the phosphorylation and degradation of IkappaBalpha and IkappaBbeta was much lower in adult cardiomyocytes than in the neonatal counterparts and macrophages. This restricted activation of the NF-kappaB pathway resulted in a significant reduction in the time of nuclear activation of NF-kappaB, as deduced by electrophoretic mobility shift assays and in the transcription of target genes, such as IkappaBalpha, cyclooxygenase-2 (COX-2) and nitric-oxide synthase-2 (NOS-2). Studies on chromatin immunoprecipitation showed binding of NF-kappaB proteins to the regulatory kappaB sites identified in the promoters of the IkappaBalpha, COX-2, and NOS-2 genes in macrophages and, to a lower extent, in neonatal cardiomyocytes. The binding to these kappaB sites in adult cardiomyocytes was observed only in the IkappaBalpha promoter and was minimal or absent in the COX-2 and NOS-2 promoters, respectively, suggesting a restricted activation of NF-kappaB-regulated genes in these cells. These data indicate that the function of the NF-kappaB pathway in adult cardiomyocytes is limited in time, which results in the expression of a reduced number of genes and provides a functional explanation for the absence of NOS-2 inducibility in these cells under proinflammatory conditions.
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Affiliation(s)
- Jimena Cuenca
- Instituto de Investigaciones Biomédicas Alberto Sols (Consejo Superior de Investigaciones Cientificas-Universidad Autónoma de Madrid, Spain
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Siegemund M, Van Bommel J, Sinaasappel M, Schwarte LA, Studer W, Girard T, Vollebregt K, Ince C. The NO donor SIN-1 improves intestinal-arterial P(CO(2)) gap in experimental endotoxemia: an animal study. Acta Anaesthesiol Scand 2007; 51:693-700. [PMID: 17567269 DOI: 10.1111/j.1399-6576.2007.01334.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Dysfunction of the microcirculation is a prominent feature of sepsis and endotoxemia. Recently, it has been shown that microcirculatory alterations are completely reversed by local or systemic application of vasodilators in severely septic patients. Therefore, we investigated the influence of vasodilator therapy on microcirculatory dysfunction of the ileum during endotoxic shock in a prospective, controlled animal study. METHODS After baseline measurements, shock was induced in 12 domestic pigs by lipopolysaccharide via the mesenteric vein until the mean arterial pressure fell below 60 mmHg. After 30 min in shock, six animals were resuscitated with either fluid alone (control) or fluid and 2 microg/kg/min of the vasodilator 3-morpholino-sydnonimine (SIN-1). The systemic and regional hemodynamics and oxygenation parameters, tonometric ileal P(CO(2)) and microvascular oxygen pressures (muP(O(2))) (by oxygen-dependent Pd-porphyrin phosphorescence) were measured simultaneously. RESULTS The ileal-arterial P(CO(2)) gap increased during shock and the ileal mucosal and serosal muP(O(2)) decreased concurrently. SIN-1 in addition to fluid resuscitation significantly improved the ileal-arterial P(CO(2)), whereas fluid alone failed to decrease the P(CO(2)) gap. The SIN-1-induced improvement in the P(CO(2)) gap was accompanied by an increase in serosal muP(O(2)) above shock levels. Mucosal muP(O(2)) was resuscitated to baseline levels in both groups. CONCLUSION The application of the vasodilator SIN-1 in addition to fluid resuscitation improves the ileal-arterial P(CO(2)) gap and mucosal muP(O(2)), together with a moderate increase in serosal muP(O(2)), after endotoxic shock. This finding is consistent with the concept that vasodilators may correct pathologic flow distribution within the intestinal wall.
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Affiliation(s)
- M Siegemund
- Department of Physiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Mastronardi C, Whelan F, Yildiz OA, Hannestad J, Elashoff D, McCann SM, Licinio J, Wong ML. Caspase 1 deficiency reduces inflammation-induced brain transcription. Proc Natl Acad Sci U S A 2007; 104:7205-10. [PMID: 17409187 PMCID: PMC1847598 DOI: 10.1073/pnas.0701366104] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2007] [Indexed: 11/18/2022] Open
Abstract
The systemic inflammatory response syndrome (SIRS) is a life-threatening medical condition characterized by a severe and generalized inflammatory state that can lead to multiple organ failure and shock. The CNS regulates many features of SIRS such as fever, cardiovascular, and neuroendocrine responses. Central and systemic manifestations of SIRS can be induced by LPS or IL-1beta administration. The crucial role of IL-1beta in inflammation has been further highlighted by studies of mice lacking caspase 1 (casp1, also known as IL-1beta convertase), a protease that cleaves pro-IL-1beta into mature IL-1beta. Indeed, casp1 knockout (casp1(-/-)) mice survive lethal doses of LPS. The key role of IL-1beta in sickness behavior and its de novo expression in the CNS during inflammation led us to test the hypothesis that IL-1beta plays a major role modulating the brain transcriptome during SIRS. We show a gene-environment effect caused by LPS administration in casp1(-/-) mice. During SIRS, the expression of several genes, such as chemokines, GTPases, the metalloprotease ADAMTS1, IL-1RA, the inducible nitric oxide synthase, and cyclooxygenase-2, was differentially increased in casp1(-/-) mice. Our findings may contribute to the understanding of the molecular changes that take place within the CNS during sepsis and SIRS and the development of new therapies for these serious conditions. Our results indicate that those genes may also play a role in several neuropsychiatric conditions in which inflammation has been implicated and indicate that casp1 might be a potential therapeutic target for such disorders.
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Affiliation(s)
- Claudio Mastronardi
- *Center on Pharmacogenomics, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136
| | - Fiona Whelan
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095-1761
| | - Ozlem A. Yildiz
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095-1761
| | - Jonas Hannestad
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095-1761
| | - David Elashoff
- Department of Biostatistics, School of Public Health and School of Nursing, University of California, Los Angeles, CA 90024; and
| | - Samuel M. McCann
- Facultad de Medicina, Centro de Estudios Farmacologicos y Botanicos–Consejo Nacional de Investigaciones Científicas y Técnicas de Argentina, Paraguay 2155, p.16. 1121 Buenos Aires, Argentina
| | - Julio Licinio
- *Center on Pharmacogenomics, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136
| | - Ma-Li Wong
- *Center on Pharmacogenomics, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136
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Nägele H, Ergin M, Azizi M, Behrens S, Jäckle S. Reversible impairment of myocardial function in Hanta virus infection – direct viral effect? Clin Res Cardiol 2006; 95:554-6. [PMID: 16845572 DOI: 10.1007/s00392-006-0419-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2006] [Accepted: 06/07/2006] [Indexed: 10/24/2022]
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Sinicina I, Matevossian E, Fischer F, Mall G, Graw M. The petrified heart in sepsis. Virchows Arch 2005; 447:875-8. [PMID: 16012848 DOI: 10.1007/s00428-005-0022-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2005] [Accepted: 05/25/2005] [Indexed: 10/25/2022]
Abstract
We report the case of a 33-year-old transsexual man who developed severe sepsis after an accidental intravenous injection of urine (3-5 ml) instead of methadone. He died unexpectedly 28 days after the onset of sepsis. On postmortem examination, the outstanding findings were restricted to the heart with an unusual macroscopic presentation. On histological examination extensive calcifications of the heart muscle, particularly of the left ventricle were found. The pattern of calcifications on the right ventricle was also striking. In contrast, the entire cardial conduction system was unaffected. Furthermore, there were no calcium deposits in other organs and tissues. The advanced widespread cardial calcifications in the present case can be attributed to endotoxin-related myocarditis in severe long-term sepsis. The only treatment would have been an urgent heart transplantation. Without prior knowledge of such a condition, it is impossible for clinicians to correctly recognize, diagnose and treat or prevent in due time such a complication.
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Affiliation(s)
- I Sinicina
- Department of Forensic Medicine, Ludwig Maximilians University Munich, Frauenlobstr. 7 a, 80337 Munich, Germany.
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