Biomarkers of cardio-renal syndrome in uremic myocardiopathy animal model

Introduction:

Cardio-renal syndrome subtype 4 (CRS4) is a condition of primary chronic kidney disease that leads to reduction of cardiac function, ventricular hypertrophy, and risk of cardiovascular events. Objective: Our aim was to understand the mechanisms involved on the onset of CRS4.

Methods:

We used the nephrectomy 5/6 (CKD) animal model and compared to control (SHAM). Serum biomarkers were analyzed at baseline, 4, and 8 weeks. After euthanasia, histology and immunohistochemistry were performed in the myocardium.

Results:

Troponin I (TnI) was increased at 4 weeks (W) and 8W, but nt-proBNP showed no difference. The greater diameter of cardiomyocytes indicated left ventricular hypertrophy and the highest levels of TNF-α were found at 4W declining in 8W while fibrosis was more intense in 8W. Angiotensin expression showed an increase at 8W.

Conclusions:

TnI seems to reflect cardiac injury as a consequence of the CKD however nt-proBNP did not change because it reflects stretching. TNF-α characterized an inflammatory peak and fibrosis increased over time in a process connecting heart and kidneys. The angiotensin showed increased activity of the renin-angiotensin axis and corroborates the hypothesis that the inflammatory process and its involvement with CRS4. Therefore, this animal study reinforces the need for renin-angiotensin blockade strategies and the control of CKD to avoid the development of CRS4.

Blood cardiac troponin in toxic myocardial injury: archetype of a translational safety biomarker

A translational safety biomarker for toxic myocardial injury is needed in drug discovery and development. This need reflects the increasing recognition of occurrence of cardiotoxicities, prior lack of preclinical blood biomarkers for toxic cardiac injury, introduction of troponin as a biomarker, and regulatory and industry drivers. Cardiac troponin is considered the gold-standard biomarker in humans for cardiac injury due to ischemic injury and drug toxicity. It has been demonstrated to correlate highly with histopathological extent of injury, degree of impairment of cardiac function, and prognosis. Numerous studies have now clearly demonstrated that both cardiac troponin T and cardiac troponin I are sensitive and specific biomarkers of cardiac injury in laboratory animals. Their use is highly recommended for incorporation into preclinical drug-safety studies, especially whenever there is any history of cardiac effect in prior studies with a compound of the same or similar chemical or pharmacological class. The main caveats with respect to cross-species use of specific cardiac troponin assays are the need for species-specific validation, definition of cut-offs based on relevant assessments of imprecision and reference ranges or concurrent controls, and knowledge of the species-dependent kinetics of release into, and clearance from, the blood. Future development of high-sensitivity assays should determine whether minimal increases below a threshold concentration of troponin might reflect reversible myocardial effects.

Temporal association of elevations in serum cardiac troponin T and myocardial oxidative stress after prolonged exercise in rats

The objective of this study was to determine if prolonged exercise resulted in the appearance of cardiac troponin T (cTnT) in serum and whether this was associated with elevated levels of myocardial oxidative stress. Forty-five male Sprague-Dawley rats were randomized into four groups and killed before (PRE-EX), immediately (0HR), 2 (2HR) and 24 h (24HR) after a 3-h bout of swimming with 5% body weight attached to their tail. In all animals serum cTnT was assayed using 3rd generation electrochemiluminescence. In homogenized heart tissue myocardial malondialdehyde (MDA), a marker of lipid peroxidation, glutathione (GSH), and a non-enzymatic estimate of total antioxidant capacity (T-AOC) were assessed spectrophotometrically. At PRE-EX cTnT was undetectable in all animals. At 0HR (median, range: 0.055, 0.020-0.100) and 2HR post-exercise (0.036, 0.016-2.110) cTnT was detectable in all animals (P < 0.05). At 24HR post-exercise cTnT was undetectable in all animals. An elevation in MDA was observed 0HR (mean ± SD: 1.7 ± 0.2 nmol mgpro(-1)) and 2HR (1.6 ± 0.3 nmol mgpro(-1)) post-exercise compared with PRE-EX (1.3 ± 0.2 nmol mgpro(-1); P < 0.05). The antioxidant response to this challenge was a significant (P < 0.05) decrease in GSH 2HR and 24HR post-exercise. Despite this T-AOC did not alter across the trial (P > 0.05). The results indicated that prolonged and strenuous exercise in rats resulted in an elevation in cTnT, a biomarker of cardiomyocyte damage, in all animals 0HR and 2HR after exercise completion. The time course of cTnT elevation was temporally associated with evidence of increased lipid peroxidation in the rat heart.

Effects of an aqueous extract of Croton bonplandianum Baill in rats

We have investigated the cytotoxic and biochemical effects of injecting aqueous phytoextract of Croton bonplandianum (Baill) leaves in male rats. Subchronic dosages of 3.25, 4.65 and 6.97mgphytoextractg(-1)b.wt.week(-1) were administered to rats. To test ameliorative effects, rats were injected with phytoextract mixed with 0.2mgg(-1)b.wt. of cyclophosphamide. Positive controls received only cyclophosphamide, while negative control groups were kept on normal diet and water. Our results demonstrate that phytoextract did not induce micronuclei formation in rats and shows insignificant amelioration (P<0.05). However, differences in serum LDH isoenzymes, ALP, SGOT, SGPT activities and bilirubin were remarkable and displayed dose as well as duration dependent variations. The most outstanding observation of this study was the release of cardiac TnI in sera of rats injected with 6.97mgg(-1)b.wt. of phytoextract for 21 days. Our findings suggest that at the highest concentrations used here phytoextract of C. bonplandianum is not clastogenic; instead it is cardio- and hepatotoxic.

Effect of denervation on the content of cardiac troponin-T and cardiac troponin-I in rat skeletal muscle

Abnormal rhabdomyocyte expression of cardiac troponin-T (cTnT) was thought to interfere with the cTnT assay. cTnT isoforms have been shown to be transiently expressed in skeletal muscle during development and in response to muscle denervation. The effect of denervation and aging on cTnT and cardiac troponin-I (cTnI) content in fast and slow rat skeletal muscles was assessed quantitatively. Sections of the tibial nerve were transected from one hind limb of both young (n=12) and old (n=12) rats. Animals were sacrificed at 1, 2, and 4 weeks after the operation, and the extensor digitorum longus (EDL) and the soleus were removed from both the denervated and the contralateral control limb. There was no significant difference in cTnI content between the fast EDL and slow soleus muscles. The cTnT content was significantly higher in the soleus than the EDL muscle (p<0.001). These data, combined with data on other models in the literature, indicate that re-expression of cTnT and cTnI isoforms in adult skeletal muscle is unlikely and does not interfere with cTnT assays for assessment of cardiac damage.

Serum chemical biomarkers of cardiac injury for nonclinical safety testing

There has been a substantial increase in the number and efficacy of laboratory biomarkers for the evaluation of human cardiac injury over the last decade. The advantages of these over traditional laboratory tests have encouraged adoption of comparable markers in nonclinical studies for cardiac injury assessment. Of particular interest are markers that are not only more sensitive and/or specific than traditional parameters for cardiac injury, but also those that may directly bridge human and laboratory animal safety testing. However, a majority of recently developed markers are quantified through antibody-based assays, and cross-reactivity with the comparable analyte in nonhuman samples is difficult to predict and often species-variable. The utility of these novel biomarkers thus, depends upon adequate assay validation with each laboratory species of interest. In contrast, traditional laboratory parameters of cardiac injury lack the properties of an ideal biomarker, but are well established and have an extensive database in nonclinical safety assessment. The current status and utility of both recently developed and traditional biomarkers of cardiac injury in nonclinical testing, and considerations for validation of novel biomarkers of cardiac injury are reviewed.