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Graczyk P, Dach A, Dyrka K, Pawlik A. Pathophysiology and Advances in the Therapy of Cardiomyopathy in Patients with Diabetes Mellitus. Int J Mol Sci 2024; 25:5027. [PMID: 38732253 PMCID: PMC11084712 DOI: 10.3390/ijms25095027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/19/2024] [Accepted: 05/01/2024] [Indexed: 05/13/2024] Open
Abstract
Diabetes mellitus (DM) is known as the first non-communicable global epidemic. It is estimated that 537 million people have DM, but the condition has been properly diagnosed in less than half of these patients. Despite numerous preventive measures, the number of DM cases is steadily increasing. The state of chronic hyperglycaemia in the body leads to numerous complications, including diabetic cardiomyopathy (DCM). A number of pathophysiological mechanisms are behind the development and progression of cardiomyopathy, including increased oxidative stress, chronic inflammation, increased synthesis of advanced glycation products and overexpression of the biosynthetic pathway of certain compounds, such as hexosamine. There is extensive research on the treatment of DCM, and there are a number of therapies that can stop the development of this complication. Among the compounds used to treat DCM are antiglycaemic drugs, hypoglycaemic drugs and drugs used to treat myocardial failure. An important element in combating DCM that should be kept in mind is a healthy lifestyle-a well-balanced diet and physical activity. There is also a group of compounds-including coenzyme Q10, antioxidants and modulators of signalling pathways and inflammatory processes, among others-that are being researched continuously, and their introduction into routine therapies is likely to result in greater control and more effective treatment of DM in the future. This paper summarises the latest recommendations for lifestyle and pharmacological treatment of cardiomyopathy in patients with DM.
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Affiliation(s)
- Patryk Graczyk
- Department of Physiology, Pomeranian Medical University, 70-111 Szczecin, Poland; (P.G.); (A.D.)
| | - Aleksandra Dach
- Department of Physiology, Pomeranian Medical University, 70-111 Szczecin, Poland; (P.G.); (A.D.)
| | - Kamil Dyrka
- Department of Pediatric Endocrinology and Rheumatology, Institute of Pediatrics, Poznan University of Medical Sciences, 60-572 Poznan, Poland;
| | - Andrzej Pawlik
- Department of Physiology, Pomeranian Medical University, 70-111 Szczecin, Poland; (P.G.); (A.D.)
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Ma X, Mei S, Wuyun Q, Zhou L, Sun D, Yan J. Epigenetics in diabetic cardiomyopathy. Clin Epigenetics 2024; 16:52. [PMID: 38581056 PMCID: PMC10996175 DOI: 10.1186/s13148-024-01667-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/28/2024] [Indexed: 04/07/2024] Open
Abstract
Diabetic cardiomyopathy (DCM) is a critical complication that poses a significant threat to the health of patients with diabetes. The intricate pathological mechanisms of DCM cause diastolic dysfunction, followed by impaired systolic function in the late stages. Accumulating researches have revealed the association between DCM and various epigenetic regulatory mechanisms, including DNA methylation, histone modifications, non-coding RNAs, and other epigenetic molecules. Recently, a profound understanding of epigenetics in the pathophysiology of DCM has been broadened owing to advanced high-throughput technologies, which assist in developing potential therapeutic strategies. In this review, we briefly introduce the epigenetics regulation and update the relevant progress in DCM. We propose the role of epigenetic factors and non-coding RNAs (ncRNAs) as potential biomarkers and drugs in DCM diagnosis and treatment, providing a new perspective and understanding of epigenomics in DCM.
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Affiliation(s)
- Xiaozhu Ma
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Shuai Mei
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Qidamugai Wuyun
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Li Zhou
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Dating Sun
- Department of Cardiology, Wuhan No. 1 Hospital, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, China
| | - Jiangtao Yan
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
- Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China.
- Genetic Diagnosis Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Abudureyimu M, Luo X, Jiang L, Jin X, Pan C, Yu W, Ge J, Zhang Y, Ren J. FBXL4 protects against HFpEF through Drp1-Mediated regulation of mitochondrial dynamics and the downstream SERCA2a. Redox Biol 2024; 70:103081. [PMID: 38359748 PMCID: PMC10878117 DOI: 10.1016/j.redox.2024.103081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/08/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024] Open
Abstract
AIMS Heart failure with preserved ejection fraction (HFpEF) is a devastating health issue although limited knowledge is available for its pathogenesis and therapeutics. Given the perceived involvement of mitochondrial dysfunction in HFpEF, this study was designed to examine the role of mitochondrial dynamics in the etiology of HFpEF. METHOD AND RESULTS Adult mice were placed on a high fat diet plus l-NAME in drinking water ('two-hit' challenge to mimic obesity and hypertension) for 15 consecutive weeks. Mass spectrometry revealed pronounced changes in mitochondrial fission protein Drp1 and E3 ligase FBXL4 in 'two-hit' mouse hearts. Transfection of FBXL4 rescued against HFpEF-compromised diastolic function, cardiac geometry, and mitochondrial integrity without affecting systolic performance, in conjunction with altered mitochondrial dynamics and integrity (hyperactivation of Drp1 and unchecked fission). Mass spectrometry and co-IP analyses unveiled an interaction between FBXL4 and Drp1 to foster ubiquitination and degradation of Drp1. Truncated mutants of FBXL4 (Delta-Fbox) disengaged interaction between FBXL4 and Drp1. Metabolomic and proteomics findings identified deranged fatty acid and glucose metabolism in HFpEF patients and mice. A cellular model was established with concurrent exposure of high glucose and palmitic acid as a 'double-damage' insult to mimic diastolic anomalies in HFpEF. Transfection of FBXL4 mitigated 'double-damage'-induced cardiomyocyte diastolic dysfunction and mitochondrial injury, the effects were abolished and mimicked by Drp1 knock-in and knock-out, respectively. HFpEF downregulated sarco(endo)plasmic reticulum (SR) Ca2+ uptake protein SERCA2a while upregulating phospholamban, RYR1, IP3R1, IP3R3 and Na+-Ca2+ exchanger with unaltered SR Ca2+ load. FBXL4 ablated 'two-hit' or 'double-damage'-induced changes in SERCA2a, phospholamban and mitochondrial injury. CONCLUSION FBXL4 rescued against HFpEF-induced cardiac remodeling, diastolic dysfunction, and mitochondrial injury through reverting hyperactivation of Drp1-mediated mitochondrial fission, underscoring the therapeutic promises of FBXL4 in HFpEF.
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Affiliation(s)
- Miyesaier Abudureyimu
- Cardiovascular Department, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, 200031, China; National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Xuanming Luo
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China; Department of General Surgery, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, 200031, China
| | - Lingling Jiang
- Cardiovascular Department, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, 200031, China; National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Xuejuan Jin
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, National Health Commission, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, Chinese Academy of Medical Sciences, Shanghai, 200032, China
| | - Cuizhen Pan
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, National Health Commission, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, Chinese Academy of Medical Sciences, Shanghai, 200032, China
| | - Wei Yu
- Xianning Medical College, Hubei University of Science and Technology, Xianning, 437100, China
| | - Junbo Ge
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, National Health Commission, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, Chinese Academy of Medical Sciences, Shanghai, 200032, China
| | - Yingmei Zhang
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, National Health Commission, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, Chinese Academy of Medical Sciences, Shanghai, 200032, China
| | - Jun Ren
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, National Health Commission, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, Chinese Academy of Medical Sciences, Shanghai, 200032, China.
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Ren AJ, Wei C, Liu YJ, Liu M, Wang P, Fan J, Wang K, Zhang S, Qin Z, Ren QX, Zheng Y, Chen YX, Xie Z, Gao L, Zhu Y, Zhang Y, Yang HT, Zhang WJ. ZBTB20 Regulates SERCA2a Activity and Myocardial Contractility Through Phospholamban. Circ Res 2024; 134:252-265. [PMID: 38166470 DOI: 10.1161/circresaha.123.323798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/20/2023] [Indexed: 01/04/2024]
Abstract
BACKGROUND Intracellular Ca2+ cycling determines myocardial contraction and relaxation in response to physiological demands. SERCA2a (sarcoplasmic/endoplasmic reticulum Ca2+-ATPase 2a) is responsible for the sequestration of cytosolic Ca2+ into intracellular stores during cardiac relaxation, and its activity is reversibly inhibited by PLN (phospholamban). However, the regulatory hierarchy of SERCA2a activity remains unclear. METHODS Cardiomyocyte-specific ZBTB20 knockout mice were generated by crossing ZBTB20flox mice with Myh6-Cre mice. Echocardiography, blood pressure measurements, Langendorff perfusion, histological analysis and immunohistochemistry, quantitative reverse transcription-PCR, Western blot analysis, electrophysiological measurements, and chromatin immunoprecipitation assay were performed to clarify the phenotype and elucidate the molecular mechanisms. RESULTS Specific ablation of ZBTB20 in cardiomyocyte led to a significant increase in basal myocardial contractile parameters both in vivo and in vitro, accompanied by an impairment in cardiac reserve and exercise capacity. Moreover, the cardiomyocytes lacking ZBTB20 showed an increase in sarcoplasmic reticular Ca2+ content and exhibited a remarkable enhancement in both SERCA2a activity and electrically stimulated contraction. Mechanistically, PLN expression was dramatically reduced in cardiomyocytes at the mRNA and protein levels by ZBTB20 deletion or silencing, and PLN overexpression could largely restore the basal contractility in ZBTB20-deficient cardiomyocytes. CONCLUSIONS These data point to ZBTB20 as a fine-tuning modulator of PLN expression and SERCA2a activity, thereby offering new perspective on the regulation of basal contractility in the mammalian heart.
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Affiliation(s)
- An-Jing Ren
- Department of Pathophysiology, Naval Medical University, Shanghai, China (A.-J.R., C.W., M.L., P.W., K.W., Z.Q., Q.-X.R., Y.-X.C., W.J.Z.)
- Experimental Teaching Center, College of Basic Medical Sciences, Naval Medical University, Shanghai, China (A.-J.R., J.F.)
| | - Chunchun Wei
- Department of Pathophysiology, Naval Medical University, Shanghai, China (A.-J.R., C.W., M.L., P.W., K.W., Z.Q., Q.-X.R., Y.-X.C., W.J.Z.)
| | - Ya-Jin Liu
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Tianjin Institute of Endocrinology and Chu Hsien-I Memorial Hospital, Tianjin Medical University Tianjin, China (Y.-J.L., Y. Zhu, W.J.Z.)
| | - Mengna Liu
- Department of Pathophysiology, Naval Medical University, Shanghai, China (A.-J.R., C.W., M.L., P.W., K.W., Z.Q., Q.-X.R., Y.-X.C., W.J.Z.)
| | - Ping Wang
- Department of Pathophysiology, Naval Medical University, Shanghai, China (A.-J.R., C.W., M.L., P.W., K.W., Z.Q., Q.-X.R., Y.-X.C., W.J.Z.)
| | - Juan Fan
- Experimental Teaching Center, College of Basic Medical Sciences, Naval Medical University, Shanghai, China (A.-J.R., J.F.)
| | - Kai Wang
- Department of Pathophysiology, Naval Medical University, Shanghai, China (A.-J.R., C.W., M.L., P.W., K.W., Z.Q., Q.-X.R., Y.-X.C., W.J.Z.)
| | - Sha Zhang
- Department of Cardiovascular Diseases, Changhai Hospital, Naval Medical University, Shanghai, China (S.Z.)
| | - Zhenbang Qin
- Department of Pathophysiology, Naval Medical University, Shanghai, China (A.-J.R., C.W., M.L., P.W., K.W., Z.Q., Q.-X.R., Y.-X.C., W.J.Z.)
| | - Qiu-Xiao Ren
- Department of Pathophysiology, Naval Medical University, Shanghai, China (A.-J.R., C.W., M.L., P.W., K.W., Z.Q., Q.-X.R., Y.-X.C., W.J.Z.)
| | - Yanjun Zheng
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Laboratory of Molecular Cardiology, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, China (Y. Zheng, H.-T.Y.)
| | - Yu-Xia Chen
- Department of Pathophysiology, Naval Medical University, Shanghai, China (A.-J.R., C.W., M.L., P.W., K.W., Z.Q., Q.-X.R., Y.-X.C., W.J.Z.)
| | - Zhifang Xie
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Institute of Early Life Health, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, China (Z.X.)
| | - Ling Gao
- Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Tongji University School of Medicine, China (L.G.)
| | - Yi Zhu
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Tianjin Institute of Endocrinology and Chu Hsien-I Memorial Hospital, Tianjin Medical University Tianjin, China (Y.-J.L., Y. Zhu, W.J.Z.)
| | - Youyi Zhang
- Institute of Vascular Medicine, National Key Laboratory of Cardiovascular Homeostasis and Remodeling, Peking University Third Hospital, Beijing, China (Y. Zhang)
| | - Huang-Tian Yang
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Laboratory of Molecular Cardiology, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, China (Y. Zheng, H.-T.Y.)
| | - Weiping J Zhang
- Department of Pathophysiology, Naval Medical University, Shanghai, China (A.-J.R., C.W., M.L., P.W., K.W., Z.Q., Q.-X.R., Y.-X.C., W.J.Z.)
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Tianjin Institute of Endocrinology and Chu Hsien-I Memorial Hospital, Tianjin Medical University Tianjin, China (Y.-J.L., Y. Zhu, W.J.Z.)
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Shao X, Tian Y, Liu J, Yan Z, Ding Y, Hao X, Wang D, Shen L, Luo E, Guo XE, Luo P, Luo W, Cai J, Jing D. Rescuing SERCA2 pump deficiency improves bone mechano-responsiveness in type 2 diabetes by shaping osteocyte calcium dynamics. Nat Commun 2024; 15:890. [PMID: 38291059 PMCID: PMC10828510 DOI: 10.1038/s41467-024-45023-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/12/2024] [Indexed: 02/01/2024] Open
Abstract
Type 2 diabetes (T2D)-related fragility fractures represent an increasingly tough medical challenge, and the current treatment options are limited. Mechanical loading is essential for maintaining bone integrity, although bone mechano-responsiveness in T2D remains poorly characterized. Herein, we report that exogenous cyclic loading-induced improvements in bone architecture and strength are compromised in both genetically spontaneous and experimentally-induced T2D mice. T2D-induced reduction in bone mechano-responsiveness is directly associated with the weakened Ca2+ oscillatory dynamics of osteocytes, although not those of osteoblasts, which is dependent on PPARα-mediated specific reduction in osteocytic SERCA2 pump expression. Treatment with the SERCA2 agonist istaroxime was demonstrated to improve T2D bone mechano-responsiveness by rescuing osteocyte Ca2+ dynamics and the associated regulation of osteoblasts and osteoclasts. Moreover, T2D-induced deterioration of bone mechano-responsiveness is blunted in mice with osteocytic SERCA2 overexpression. Collectively, our study provides mechanistic insights into T2D-mediated deterioration of bone mechano-responsiveness and identifies a promising countermeasure against T2D-associated fragility fractures.
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Affiliation(s)
- Xi Shao
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | - Yulan Tian
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | - Juan Liu
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | - Zedong Yan
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | - Yuanjun Ding
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | - Xiaoxia Hao
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | - Dan Wang
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | - Liangliang Shen
- The State Key Laboratory of Cancer Biology, Department of Biochemistry and Molecular Biology, Fourth Military Medical University, Xi'an, China
| | - Erping Luo
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | - X Edward Guo
- Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Peng Luo
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
| | - Wenjing Luo
- The Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Fourth Military Medical University, Xi'an, China.
| | - Jing Cai
- College of Basic Medicine, Shaanxi University of Chinese Medicine, Xianyang, China.
| | - Da Jing
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, China.
- The Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Fourth Military Medical University, Xi'an, China.
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Arici M, Hsu SC, Ferrandi M, Barassi P, Ronchi C, Torre E, Luraghi A, Chang GJ, Ferrari P, Bianchi G, Peri F, Zaza A, Rocchetti M. Selective SERCA2a activator as a candidate for chronic heart failure therapy. J Transl Med 2024; 22:77. [PMID: 38243248 PMCID: PMC10797746 DOI: 10.1186/s12967-024-04874-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/08/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND The sarcoplasmic reticulum (SR) Ca2+ ATPase (SERCA2a) depression substantially contributes to diastolic dysfunction in heart failure (HF), suggesting that SERCA2a stimulation may be a mechanism-based HF therapy. Istaroxime is a drug endowed with both a SERCA2a stimulatory activity and a Na+/K+ pump inhibitory activity for acute HF treatment. Its main metabolite PST3093 shows a more favorable therapeutic profile as compared to the parent drug, but it is still unsuitable for chronic usage. Novel PST3093 derivatives have been recently developed for oral (chronic) HF treatment; compound 8 was selected among them and here characterized. METHODS Effects of compound 8 were evaluated in a context of SERCA2a depression, by using streptozotocin-treated rats, a well-known model of diastolic dysfunction. The impact of SERCA2a stimulation by compound 8 was assessed at the cellular level ad in vivo, following i.v. infusion (acute effects) or oral administration (chronic effects). RESULTS As expected from SERCA2a stimulation, compound 8 induced SR Ca2+ compartmentalization in STZ myocytes. In-vivo echocardiographic analysis during i.v. infusion and after repeated oral administration of compound 8, detected a significant improvement of diastolic function. Moreover, compound 8 did not affect electrical activity of healthy guinea-pig myocytes, in line with the absence of off-target effects. Finally, compound 8 was well tolerated in mice with no evidence of acute toxicity. CONCLUSIONS The pharmacological evaluation of compound 8 indicates that it may be a safe and selective drug for a mechanism-based treatment of chronic HF by restoring SERCA2a activity.
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Affiliation(s)
- Martina Arici
- Department of Biotechnology and Biosciences, Università Degli Studi di Milano-Bicocca, P.Za Della Scienza 2, 20126, Milan, Italy
| | - Shih-Che Hsu
- CVie Therapeutics Limited, Taipei, 11047, Taiwan
| | - Mara Ferrandi
- Windtree Therapeutics Inc, Warrington, PA, 18976, USA
| | - Paolo Barassi
- Windtree Therapeutics Inc, Warrington, PA, 18976, USA
| | - Carlotta Ronchi
- Department of Biotechnology and Biosciences, Università Degli Studi di Milano-Bicocca, P.Za Della Scienza 2, 20126, Milan, Italy
| | - Eleonora Torre
- Department of Biotechnology and Biosciences, Università Degli Studi di Milano-Bicocca, P.Za Della Scienza 2, 20126, Milan, Italy
| | - Andrea Luraghi
- Department of Biotechnology and Biosciences, Università Degli Studi di Milano-Bicocca, P.Za Della Scienza 2, 20126, Milan, Italy
| | | | | | - Giuseppe Bianchi
- Windtree Therapeutics Inc, Warrington, PA, 18976, USA
- Università Vita-Salute San Raffaele, 20132, Milan, Italy
| | - Francesco Peri
- Department of Biotechnology and Biosciences, Università Degli Studi di Milano-Bicocca, P.Za Della Scienza 2, 20126, Milan, Italy
| | - Antonio Zaza
- Department of Biotechnology and Biosciences, Università Degli Studi di Milano-Bicocca, P.Za Della Scienza 2, 20126, Milan, Italy.
| | - Marcella Rocchetti
- Department of Biotechnology and Biosciences, Università Degli Studi di Milano-Bicocca, P.Za Della Scienza 2, 20126, Milan, Italy.
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Ronchi C, Galli C, Tullii G, Marzuoli C, Mazzola M, Malferrari M, Crasto S, Rapino S, Di Pasquale E, Antognazza MR. Nongenetic Optical Modulation of Pluripotent Stem Cells Derived Cardiomyocytes Function in the Red Spectral Range. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2304303. [PMID: 37948328 PMCID: PMC10797444 DOI: 10.1002/advs.202304303] [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: 06/27/2023] [Revised: 09/24/2023] [Indexed: 11/12/2023]
Abstract
Optical stimulation in the red/near infrared range recently gained increasing interest, as a not-invasive tool to control cardiac cell activity and repair in disease conditions. Translation of this approach to therapy is hampered by scarce efficacy and selectivity. The use of smart biocompatible materials, capable to act as local, NIR-sensitive interfaces with cardiac cells, may represent a valuable solution, capable to overcome these limitations. In this work, a far red-responsive conjugated polymer, namely poly[2,1,3-benzothiadiazole-4,7-diyl[4,4-bis(2-ethylhexyl)-4H-cyclopenta[2,1-b:3,4-b']dithiophene-2,6-diyl]] (PCPDTBT) is proposed for the realization of photoactive interfaces with cardiomyocytes derived from pluripotent stem cells (hPSC-CMs). Optical excitation of the polymer turns into effective ionic and electrical modulation of hPSC-CMs, in particular by fastening Ca2+ dynamics, inducing action potential shortening, accelerating the spontaneous beating frequency. The involvement in the phototransduction pathway of Sarco-Endoplasmic Reticulum Calcium ATPase (SERCA) and Na+ /Ca2+ exchanger (NCX) is proven by pharmacological assays and is correlated with physical/chemical processes occurring at the polymer surface upon photoexcitation. Very interestingly, an antiarrhythmogenic effect, unequivocally triggered by polymer photoexcitation, is also observed. Overall, red-light excitation of conjugated polymers may represent an unprecedented opportunity for fine control of hPSC-CMs functionality and can be considered as a perspective, noninvasive approach to treat arrhythmias.
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Affiliation(s)
- Carlotta Ronchi
- Center for Nano Science and TechnologyIstituto Italiano di TecnologiaMilano20133Italy
| | - Camilla Galli
- Humanitas Cardio CenterIRCCS Humanitas Research HospitalVia Manzoni 56RozzanoMilan20089Italy
| | - Gabriele Tullii
- Center for Nano Science and TechnologyIstituto Italiano di TecnologiaMilano20133Italy
| | - Camilla Marzuoli
- Center for Nano Science and TechnologyIstituto Italiano di TecnologiaMilano20133Italy
- Politecnico di MilanoPhysics Dept.P.zza L. Da Vinci 32Milano20133Italy
| | - Marta Mazzola
- Humanitas Cardio CenterIRCCS Humanitas Research HospitalVia Manzoni 56RozzanoMilan20089Italy
| | - Marco Malferrari
- Department of Chemistry, University of Bologna‘‘Giacomo Ciamician,’’via Francesco Selmi 2Bologna40126Italy
| | - Silvia Crasto
- Humanitas Cardio CenterIRCCS Humanitas Research HospitalVia Manzoni 56RozzanoMilan20089Italy
| | - Stefania Rapino
- Department of Chemistry, University of Bologna‘‘Giacomo Ciamician,’’via Francesco Selmi 2Bologna40126Italy
| | - Elisa Di Pasquale
- Humanitas Cardio CenterIRCCS Humanitas Research HospitalVia Manzoni 56RozzanoMilan20089Italy
- Institute of Genetic and Biomedical Research (IRGB)UOS of Milan—National Research Council of Italy (CNR)Milan20138Italy
| | - Maria Rosa Antognazza
- Center for Nano Science and TechnologyIstituto Italiano di TecnologiaMilano20133Italy
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8
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He X, Li X, Yan M, Peng H, Zhang L, Liang Y, Tang W, Li S. Cardiac function evaluation in children with spinal muscular atrophy: A case-control study. Pediatr Int 2024; 66:e15769. [PMID: 38742693 DOI: 10.1111/ped.15769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/09/2024] [Accepted: 03/04/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Spinal muscular atrophy (SMA) is an autosomal recessive disorder characterized by degeneration of lower motor neurons, resulting in progressive muscle weakness and atrophy. However, little is known regarding the cardiac function of children with SMA. METHODS We recruited SMA patients younger than 18 years of age from January 1, 2022, to April 1, 2022, in the First Affiliated Hospital of Sun Yat-sen University. All patients underwent a comprehensive cardiac evaluation before treatment, including history taking, physical examination, blood tests of cardiac biomarkers, assessment of echocardiography and electrocardiogram. Age/gender-matched healthy volunteers were recruited as controls. RESULTS A total of 36 SMA patients (26 with SMA type 2 and 10 with SMA type 3) and 40 controls were enrolled in the study. No patient was clinically diagnosed with heart failure. Blood tests showed elevated values of creatine kinase isoenzyme M and isoenzyme B (CK-MB) mass and high-sensitivity cardiac troponin T (hs-cTnT) in spinal muscular atrophy (SMA) patients. Regarding echocardiographic parameters, SMA children were detected with lower global left and right ventricular longitudinal strain, abnormal diastolic filling velocities of trans-mitral and trans-tricuspid flow. The results revealed no clinical heart dysfunction in SMA patients, but subclinical ventricular dysfunction was seen in SMA children including the diastolic function and myocardial performance. Some patients presented with elevated heart rate and abnormal echogenicity of aortic valve or wall. Among these SMA patients, seven patients (19.4%) had scoliosis. The Cobb's angles showed a significant negative correlation with LVEDd/BSA, but no correlation with other parameters, suggesting that mild scoliosis did not lead to significant cardiac dysfunction. CONCLUSIONS Our findings warrant increased attention to the cardiac status and highlight the need to investigate cardiac interventions in SMA children.
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Affiliation(s)
- Xiufang He
- Department of Pediatric Cardiology, Heart Center, The First Affiliated Hospital of Sun Yat-sen University, and NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China
| | - Xuandi Li
- Department of Pediatric Cardiology, Heart Center, The First Affiliated Hospital of Sun Yat-sen University, and NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China
| | - Mengzhen Yan
- Department of PICU, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huimin Peng
- Department of Pediatric Cardiology, Heart Center, The First Affiliated Hospital of Sun Yat-sen University, and NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China
| | - Lili Zhang
- Department of Pediatric Cardiology, Heart Center, The First Affiliated Hospital of Sun Yat-sen University, and NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China
| | - Yujian Liang
- Department of PICU, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wen Tang
- Department of PICU, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shujuan Li
- Department of Pediatric Cardiology, Heart Center, The First Affiliated Hospital of Sun Yat-sen University, and NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China
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9
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Dattani A, Singh A, McCann GP, Gulsin GS. Myocardial Calcium Handling in Type 2 Diabetes: A Novel Therapeutic Target. J Cardiovasc Dev Dis 2023; 11:12. [PMID: 38248882 PMCID: PMC10817027 DOI: 10.3390/jcdd11010012] [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: 11/06/2023] [Revised: 12/20/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
Type 2 diabetes (T2D) is a multisystem disease with rapidly increasing global prevalence. Heart failure has emerged as a major complication of T2D. Dysregulated myocardial calcium handling is evident in the failing heart and this may be a key driver of cardiomyopathy in T2D, but until recently this has only been demonstrated in animal models. In this review, we describe the physiological concepts behind calcium handling within the cardiomyocyte and the application of novel imaging techniques for the quantification of myocardial calcium uptake. We take an in-depth look at the evidence for the impairment of calcium handling in T2D using pre-clinical models as well as in vivo studies, following which we discuss potential novel therapeutic approaches targeting dysregulated myocardial calcium handling in T2D.
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Affiliation(s)
- Abhishek Dattani
- Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Biomedical Research Centre, Leicester LE3 9QP, UK; (A.S.); (G.P.M.); (G.S.G.)
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10
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Mitronova GY, Quentin C, Belov VN, Wegener JW, Kiszka KA, Lehnart SE. 1,4-Benzothiazepines with Cyclopropanol Groups and Their Structural Analogues Exhibit Both RyR2-Stabilizing and SERCA2a-Stimulating Activities. J Med Chem 2023; 66:15761-15775. [PMID: 37991191 PMCID: PMC10726367 DOI: 10.1021/acs.jmedchem.3c01235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/24/2023] [Accepted: 11/07/2023] [Indexed: 11/23/2023]
Abstract
To discover new multifunctional agents for the treatment of cardiovascular diseases, we designed and synthesized a series of compounds with a cyclopropyl alcohol moiety and evaluated them in biochemical assays. Biological screening identified derivatives with dual activity: preventing Ca2+ leak through ryanodine receptor 2 (RyR2) and enhancing cardiac sarco-endoplasmic reticulum (SR) Ca2+ load by activation of Ca2+-dependent ATPase 2a (SERCA2a). The compounds that stabilize RyR2 at micro- and nanomolar concentrations are either structurally related to RyR-stabilizing drugs or Rycals or have structures similar to them. The novel compounds also demonstrate a good ability to increase ATP hydrolysis mediated by SERCA2a activity in cardiac microsomes, e.g., the half-maximal effective concentration (EC50) was as low as 383 nM for compound 12a, which is 1,4-benzothiazepine with two cyclopropanol groups. Our findings indicate that these derivatives can be considered as new lead compounds to improve cardiac function in heart failure.
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Affiliation(s)
- Gyuzel Y. Mitronova
- Department
of NanoBiophotonics, Max Planck Institute
for Multidisciplinary Sciences, Am Fassberg 11, Göttingen 37077, Germany
- German
Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen 37075, Germany
| | - Christine Quentin
- Department
of NanoBiophotonics, Max Planck Institute
for Multidisciplinary Sciences, Am Fassberg 11, Göttingen 37077, Germany
| | - Vladimir N. Belov
- Department
of NanoBiophotonics, Max Planck Institute
for Multidisciplinary Sciences, Am Fassberg 11, Göttingen 37077, Germany
| | - Jörg W. Wegener
- Department
of Cardiology & Pulmonology, Heart Research Center Göttingen, University Medical Center Göttingen, Robert-Koch-Strasse 42a, Göttingen 37075, Germany
- German
Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen 37075, Germany
| | - Kamila A. Kiszka
- Department
of NanoBiophotonics, Max Planck Institute
for Multidisciplinary Sciences, Am Fassberg 11, Göttingen 37077, Germany
| | - Stephan E. Lehnart
- Department
of Cardiology & Pulmonology, Heart Research Center Göttingen, University Medical Center Göttingen, Robert-Koch-Strasse 42a, Göttingen 37075, Germany
- German
Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen 37075, Germany
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11
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Gok E, Unal N, Gungor B, Karakus G, Kaya S, Canturk P, Katin KP. Evaluation of the Anticancer and Biological Activities of Istaroxime via Ex Vivo Analyses, Molecular Docking and Conceptual Density Functional Theory Computations. Molecules 2023; 28:7458. [PMID: 38005181 PMCID: PMC10672917 DOI: 10.3390/molecules28227458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/11/2023] [Accepted: 10/18/2023] [Indexed: 11/26/2023] Open
Abstract
Cancer is a disease that occurs as a result of abnormal or uncontrolled growth of cells due to DNA damage, among many other causes. Certain cancer treatments aim to increase the excess of DNA breaks to such an extent that they cannot escape from the general mechanism of cell checkpoints, leading to the apoptosis of mutant cells. In this study, one of the Sarco-endoplasmic reticulum Ca2+ATPase (SERCA2a) inhibitors, Istaroxime, was investigated. There has been very limited number of articles so far reporting Istaroxime's anticancer activity; thus, we aimed to evaluate the anticancer effects of Istaroxime by cell proliferation assay and revealed the cytotoxic activity of the compound. We further determined the interaction of Istaroxime with topoisomerase enzymes through enzyme activity tests and detailed molecular modeling analysis. Istaroxime exhibited an antiproliferative effect on A549, MCF7, and PC3 cell lines and inhibited Topoisomerase I, suggesting that Istaroxime can act as a Topoisomerase I inhibitor under in vitro conditions. Molecular docking analysis supported the experimental observations. A chemical reactivity analysis of the Istaroxime molecule was made in the light of Density Functional Theory computations. For this aim, important chemical reactivity descriptors such as hardness, electronegativity, and electrophilicity were computed and discussed as detailed.
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Affiliation(s)
- Ege Gok
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Sivas Cumhuriyet University, 58140 Sivas, Turkey;
| | - Naz Unal
- Department of Biochemistry, Faculty of Pharmacy, Yeditepe University, 34755 Istanbul, Turkey; (N.U.); (B.G.)
| | - Burcin Gungor
- Department of Biochemistry, Faculty of Pharmacy, Yeditepe University, 34755 Istanbul, Turkey; (N.U.); (B.G.)
| | - Gulderen Karakus
- Department of Pharmaceutical Basic Sciences, Faculty of Pharmacy, Sivas Cumhuriyet University, 58140 Sivas, Turkey;
| | - Savas Kaya
- Department of Chemistry, Faculty of Science, Sivas Cumhuriyet University, 58140 Sivas, Turkey
| | - Pakize Canturk
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Sivas Cumhuriyet University, 58140 Sivas, Turkey;
| | - Konstantin P. Katin
- Nanoengineering in Electronics, Spintronics and Photonics Institute, National Research Nuclear University MEPhI, 115409 Moscow, Russia;
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12
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Luo Y, Zhou S, Xu T, Wu W, Shang P, Wang S, Pan D, Li D. SENP2-mediated SERCA2a deSUMOylation increases calcium overload in cardiomyocytes to aggravate myocardial ischemia/reperfusion injury. Chin Med J (Engl) 2023; 136:2496-2507. [PMID: 37462038 PMCID: PMC10586866 DOI: 10.1097/cm9.0000000000002757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Sarcoplasmic reticulum calcium ATPase 2a (SERCA2a) is a key protein that maintains myocardial Ca 2+ homeostasis. The present study aimed to investigate the mechanism underlying the SERCA2a-SUMOylation (small ubiquitin-like modifier) process after ischemia/reperfusion injury (I/RI) in vitro and in vivo . METHODS Calcium transient and systolic/diastolic function of cardiomyocytes isolated from Serca2a knockout (KO) and wild-type mice with I/RI were compared. SUMO-relevant protein expression and localization were detected by quantitative real-time PCR (RT-qPCR), Western blotting, and immunofluorescence in vitro and in vivo . Serca2a-SUMOylation, infarct size, and cardiac function of Senp1 or Senp2 overexpressed/suppressed adenovirus infected cardiomyocytes, were detected by immunoprecipitation, triphenyltetrazolium chloride (TTC)-Evans blue staining, and echocardiography respectively. RESULTS The results showed that the changes of Fura-2 fluorescence intensity and contraction amplitude of cardiomyocytes decreased in the I/RI groups and were further reduced in the Serca2a KO + I/RI groups. Senp1 and Senp2 messenger ribose nucleic acid (mRNA) and protein expression levels in vivo and in cardiomyocytes were highest at 6 h and declined at 12 h after I/RI. However, the highest levels in HL-1 cells were recorded at 12 h. Senp2 expression increased in the cytoplasm, unlike that of Senp1. Inhibition of Senp2 protein reversed the I/RI-induced Serca2a-SUMOylation decline, reduced the infarction area, and improved cardiac function, while inhibition of Senp1 protein could not restore the above indicators. CONCLUSION I/RI activated Senp1 and Senp2 protein expression, which promoted Serca2a-deSUMOylation, while inhibition of Senp2 expression reversed Serca2a-SUMOylation and improved cardiac function.
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Affiliation(s)
- Yuanyuan Luo
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, China
| | - Shuaishuai Zhou
- Institute of Cardiovascular Disease Research, Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
| | - Tao Xu
- Institute of Cardiovascular Disease Research, Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
| | - Wanling Wu
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, China
| | - Pingping Shang
- Institute of Cardiovascular Disease Research, Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
| | - Shuai Wang
- Institute of Cardiovascular Disease Research, Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
| | - Defeng Pan
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, China
| | - Dongye Li
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, China
- Institute of Cardiovascular Disease Research, Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
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13
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Huo JL, Feng Q, Pan S, Fu WJ, Liu Z, Liu Z. Diabetic cardiomyopathy: Early diagnostic biomarkers, pathogenetic mechanisms, and therapeutic interventions. Cell Death Discov 2023; 9:256. [PMID: 37479697 PMCID: PMC10362058 DOI: 10.1038/s41420-023-01553-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/06/2023] [Accepted: 07/12/2023] [Indexed: 07/23/2023] Open
Abstract
Diabetic cardiomyopathy (DCM) mainly refers to myocardial metabolic dysfunction caused by high glucose, and hyperglycemia is an independent risk factor for cardiac function in the absence of coronary atherosclerosis and hypertension. DCM, which is a severe complication of diabetes, has become the leading cause of heart failure in diabetic patients. The initial symptoms are inconspicuous, and patients gradually exhibit left ventricular dysfunction and eventually develop total heart failure, which brings a great challenge to the early diagnosis of DCM. To date, the underlying pathological mechanisms of DCM are complicated and have not been fully elucidated. Although there are therapeutic strategies available for DCM, the treatment is mainly focused on controlling blood glucose and blood lipids, and there is a lack of effective drugs targeting myocardial injury. Thus, a large percentage of patients with DCM inevitably develop heart failure. Given the neglected initial symptoms, the intricate cellular and molecular mechanisms, and the lack of available drugs, it is necessary to explore early diagnostic biomarkers, further understand the signaling pathways involved in the pathogenesis of DCM, summarize the current therapeutic strategies, and develop new targeted interventions.
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Affiliation(s)
- Jin-Ling Huo
- Traditional Chinese Medicine Integrated Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, P. R. China
- Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, P. R. China
- Henan Province Research Center For Kidney Disease, Zhengzhou, 450052, P. R. China
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, 450052, P. R. China
| | - Qi Feng
- Traditional Chinese Medicine Integrated Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, P. R. China
- Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, P. R. China
- Henan Province Research Center For Kidney Disease, Zhengzhou, 450052, P. R. China
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, 450052, P. R. China
| | - Shaokang Pan
- Traditional Chinese Medicine Integrated Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, P. R. China
- Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, P. R. China
- Henan Province Research Center For Kidney Disease, Zhengzhou, 450052, P. R. China
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, 450052, P. R. China
| | - Wen-Jia Fu
- Traditional Chinese Medicine Integrated Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, P. R. China
- Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, P. R. China
- Henan Province Research Center For Kidney Disease, Zhengzhou, 450052, P. R. China
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, 450052, P. R. China
| | - Zhangsuo Liu
- Traditional Chinese Medicine Integrated Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, P. R. China.
- Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, P. R. China.
- Henan Province Research Center For Kidney Disease, Zhengzhou, 450052, P. R. China.
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, 450052, P. R. China.
| | - Zhenzhen Liu
- Department of Chinese Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, P. R. China.
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14
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Kho C. Targeting calcium regulators as therapy for heart failure: focus on the sarcoplasmic reticulum Ca-ATPase pump. Front Cardiovasc Med 2023; 10:1185261. [PMID: 37534277 PMCID: PMC10392702 DOI: 10.3389/fcvm.2023.1185261] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/06/2023] [Indexed: 08/04/2023] Open
Abstract
Impaired myocardial Ca2+ cycling is a critical contributor to the development of heart failure (HF), causing changes in the contractile function and structure remodeling of the heart. Within cardiomyocytes, the regulation of sarcoplasmic reticulum (SR) Ca2+ storage and release is largely dependent on Ca2+ handling proteins, such as the SR Ca2+ ATPase (SERCA2a) pump. During the relaxation phase of the cardiac cycle (diastole), SERCA2a plays a critical role in transporting cytosolic Ca2+ back to the SR, which helps to restore both cytosolic Ca2+ levels to their resting state and SR Ca2+ content for the next contraction. However, decreased SERCA2a expression and/or pump activity are key features in HF. As a result, there is a growing interest in developing therapeutic approaches to target SERCA2a. This review provides an overview of the regulatory mechanisms of the SERCA2a pump and explores potential strategies for SERCA2a-targeted therapy, which are being investigated in both preclinical and clinical studies.
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Affiliation(s)
- Changwon Kho
- Division of Applied Medicine, School of Korean Medicine, Pusan National University, Yangsan, Republic of Korea
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15
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Emerging Therapy for Diabetic Cardiomyopathy: From Molecular Mechanism to Clinical Practice. Biomedicines 2023; 11:biomedicines11030662. [PMID: 36979641 PMCID: PMC10045486 DOI: 10.3390/biomedicines11030662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/08/2023] [Accepted: 02/11/2023] [Indexed: 02/24/2023] Open
Abstract
Diabetic cardiomyopathy is characterized by abnormal myocardial structure or performance in the absence of coronary artery disease or significant valvular heart disease in patients with diabetes mellitus. The spectrum of diabetic cardiomyopathy ranges from subtle myocardial changes to myocardial fibrosis and diastolic function and finally to symptomatic heart failure. Except for sodium–glucose transport protein 2 inhibitors and possibly bariatric and metabolic surgery, there is currently no specific treatment for this distinct disease entity in patients with diabetes. The molecular mechanism of diabetic cardiomyopathy includes impaired nutrient-sensing signaling, dysregulated autophagy, impaired mitochondrial energetics, altered fuel utilization, oxidative stress and lipid peroxidation, advanced glycation end-products, inflammation, impaired calcium homeostasis, abnormal endothelial function and nitric oxide production, aberrant epidermal growth factor receptor signaling, the activation of the renin–angiotensin–aldosterone system and sympathetic hyperactivity, and extracellular matrix accumulation and fibrosis. Here, we summarize several important emerging treatments for diabetic cardiomyopathy targeting specific molecular mechanisms, with evidence from preclinical studies and clinical trials.
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16
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Mauro C, Chianese S, Cocchia R, Arcopinto M, Auciello S, Capone V, Carafa M, Carbone A, Caruso G, Castaldo R, Citro R, Crisci G, D’Andrea A, D’Assante R, D’Avino M, Ferrara F, Frangiosa A, Galzerano D, Maffei V, Marra AM, Mehta RM, Mehta RH, Paladino F, Ranieri B, Franzese M, Limongelli G, Rega S, Romano L, Salzano A, Sepe C, Vriz O, Izzo R, Cademartiri F, Cittadini A, Bossone E. Acute Heart Failure: Diagnostic-Therapeutic Pathways and Preventive Strategies-A Real-World Clinician's Guide. J Clin Med 2023; 12:jcm12030846. [PMID: 36769495 PMCID: PMC9917599 DOI: 10.3390/jcm12030846] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/01/2023] [Accepted: 01/16/2023] [Indexed: 01/25/2023] Open
Abstract
Acute heart failure (AHF) is the most frequent cause of unplanned hospital admission in patients of >65 years of age and it is associated with significantly increased morbidity, mortality, and healthcare costs. Different AHF classification criteria have been proposed, mainly reflecting the clinical heterogeneity of the syndrome. Regardless of the underlying mechanism, peripheral and/or pulmonary congestion is present in the vast majority of cases. Furthermore, a marked reduction in cardiac output with peripheral hypoperfusion may occur in most severe cases. Diagnosis is made on the basis of signs and symptoms, laboratory, and non-invasive tests. After exclusion of reversible causes, AHF therapeutic interventions mainly consist of intravenous (IV) diuretics and/or vasodilators, tailored according to the initial hemodynamic status with the addition of inotropes/vasopressors and mechanical circulatory support if needed. The aim of this review is to discuss current concepts on the diagnosis and management of AHF in order to guide daily clinical practice and to underline the unmet needs. Preventive strategies are also discussed.
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Affiliation(s)
- Ciro Mauro
- Cardiology Division, A. Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
| | - Salvatore Chianese
- Cardiology Division, A. Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Rosangela Cocchia
- Cardiology Division, A. Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
| | - Michele Arcopinto
- Department of Translational Medical Sciences, Federico II University, 80131 Naples, Italy
| | - Stefania Auciello
- First Aid—Short Intensive Observation Division, A. Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
| | - Valentina Capone
- Cardiology Division, A. Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Mariano Carafa
- Emergency Medicine Division, A. Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
| | - Andreina Carbone
- Unit of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy
| | - Giuseppe Caruso
- Long-Term Care Division, Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
| | - Rossana Castaldo
- Istituto di Ricovero e Cura a Carattere Scientifico SYNLAB SDN, Via Emanuele Gianturco, 113, 80143 Naples, Italy
| | - Rodolfo Citro
- Heart Department, University Hospital of Salerno, 84131 Salerno, Italy
| | - Giulia Crisci
- Department of Translational Medical Sciences, Federico II University, 80131 Naples, Italy
| | - Antonello D’Andrea
- Department of Cardiology, Umberto I Hospital Nocera Inferiore, 84014 Nocera, Italy
| | - Roberta D’Assante
- Department of Translational Medical Sciences, Federico II University, 80131 Naples, Italy
| | - Maria D’Avino
- Long-Term Care Division, Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
| | - Francesco Ferrara
- Heart Department, University Hospital of Salerno, 84131 Salerno, Italy
| | - Antonio Frangiosa
- Post Operative Intensive Care Division, A. Cardarelli Hospital, 80131 Naples, Italy
| | - Domenico Galzerano
- Heart Centre, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Vincenzo Maffei
- Post Operative Intensive Care Division, A. Cardarelli Hospital, 80131 Naples, Italy
| | - Alberto Maria Marra
- Department of Translational Medical Sciences, Federico II University, 80131 Naples, Italy
| | - Rahul M. Mehta
- ProMedica Monroe Regional Hospital, Monroe, MI 48162, USA
| | - Rajendra H. Mehta
- Duke Clinical Research Institute, 300 W Morgan St., Durham, NC 27701, USA
| | - Fiorella Paladino
- First Aid—Short Intensive Observation Division, A. Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
| | - Brigida Ranieri
- Istituto di Ricovero e Cura a Carattere Scientifico SYNLAB SDN, Via Emanuele Gianturco, 113, 80143 Naples, Italy
| | - Monica Franzese
- Istituto di Ricovero e Cura a Carattere Scientifico SYNLAB SDN, Via Emanuele Gianturco, 113, 80143 Naples, Italy
| | - Giuseppe Limongelli
- Unit of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy
| | - Salvatore Rega
- Department of Public Health University “Federico II” of Naples, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Luigia Romano
- Department of General and Emergency Radiology, Antonio Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
| | - Andrea Salzano
- Istituto di Ricovero e Cura a Carattere Scientifico SYNLAB SDN, Via Emanuele Gianturco, 113, 80143 Naples, Italy
| | - Chiara Sepe
- Technical Nursing and Rehabilitation Service (SITR) Department, Cardarelli Hospital, 80131 Naples, Italy
| | - Olga Vriz
- Heart Centre, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Raffaele Izzo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Filippo Cademartiri
- Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Via Moruzzi, 1, 56124 Pisa, Italy
| | - Antonio Cittadini
- Department of Translational Medical Sciences, Federico II University, 80131 Naples, Italy
| | - Eduardo Bossone
- Department of Public Health University “Federico II” of Naples, Via Sergio Pansini, 5, 80131 Naples, Italy
- Correspondence:
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Arici M, Ferrandi M, Barassi P, Hsu SC, Torre E, Luraghi A, Ronchi C, Chang GJ, Peri F, Ferrari P, Bianchi G, Rocchetti M, Zaza A. Istaroxime Metabolite PST3093 Selectively Stimulates SERCA2a and Reverses Disease-Induced Changes in Cardiac Function. J Pharmacol Exp Ther 2023; 384:231-244. [PMID: 36153005 DOI: 10.1124/jpet.122.001335] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/11/2022] [Accepted: 08/01/2022] [Indexed: 01/03/2023] Open
Abstract
Heart failure (HF) therapeutic toolkit would strongly benefit from the availability of ino-lusitropic agents with a favorable pharmacodynamics and safety profile. Istaroxime is a promising agent, which combines Na+/K+ pump inhibition with sarcoplasmic reticulum Ca2+ ATPase (SERCA2a) stimulation; however, it has a very short half-life and extensive metabolism to a molecule named PST3093. The present work aims to investigate whether PST3093 still retains the pharmacodynamic and pharmacokinetic properties of its parent compound. We studied PST3093 for its effects on SERCA2a and Na+/K+ ATPase activities, Ca2+ dynamics in isolated myocytes, and hemodynamic effects in an in vivo rat model of diabetic [streptozotocin (STZ)-induced] cardiomyopathy. Istaroxime infusion in HF patients led to accumulation of PST3093 in the plasma; clearance was substantially slower for PST3093 than for istaroxime. In cardiac rat preparations, PST3093 did not inhibit the Na+/K+ ATPase activity but retained SERCA2a stimulatory activity. In in vivo echocardiographic assessment, PST3093 improved overall cardiac performance and reversed most STZ-induced abnormalities. PST3093 intravenous toxicity was considerably lower than that of istaroxime, and it failed to significantly interact with 50 off-targets. Overall, PST3093 is a "selective" SERCA2a activator, the prototype of a novel pharmacodynamic category with a potential in the ino-lusitropic approach to HF with prevailing diastolic dysfunction. Its pharmacodynamics are peculiar, and its pharmacokinetics are suitable to prolong the cardiac beneficial effect of istaroxime infusion. SIGNIFICANCE STATEMENT: Heart failure (HF) treatment would benefit from the availability of ino-lusitropic agents with favourable profiles. PST3093 is the main metabolite of istaroxime, a promising agent combining Na+/K+ pump inhibition and sarcoplasmic reticulum Ca2+ ATPase2a (SERCA2a) stimulation. PST3093 shows a longer half-life in human circulation compared to istaroxime, selectively activates SERCA2a, and improves cardiac performance in a model of diabetic cardiomyopathy. Overall, PST3093 as a selective SERCA2a activator can be considered the prototype of a novel pharmacodynamic category for HF treatment.
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Affiliation(s)
- Martina Arici
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Mara Ferrandi
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Paolo Barassi
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Shih-Che Hsu
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Eleonora Torre
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Andrea Luraghi
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Carlotta Ronchi
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Gwo-Jyh Chang
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Francesco Peri
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Patrizia Ferrari
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Giuseppe Bianchi
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Marcella Rocchetti
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Antonio Zaza
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
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18
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Avvisato R, Jankauskas SS, Santulli G. Istaroxime and Beyond: New Therapeutic Strategies to Specifically Activate SERCA and Treat Heart Failure. J Pharmacol Exp Ther 2023; 384:227-230. [PMID: 36581352 DOI: 10.1124/jpet.122.001446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/17/2022] [Indexed: 12/31/2022] Open
Affiliation(s)
- Roberta Avvisato
- Department of Medicine, Division of Cardiology, Wilf Family Cardiovascular Research Institute, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Einstein Institute for Aging Research (R.A., S.S.J., G.S.) and Department of Molecular Pharmacology, Institute for Neuroimmunology and Inflammation, Fleischer Institute for Diabetes and Metabolism (FIDAM) (G.S.), Albert Einstein College of Medicine, New York, New York
| | - Stanislovas S Jankauskas
- Department of Medicine, Division of Cardiology, Wilf Family Cardiovascular Research Institute, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Einstein Institute for Aging Research (R.A., S.S.J., G.S.) and Department of Molecular Pharmacology, Institute for Neuroimmunology and Inflammation, Fleischer Institute for Diabetes and Metabolism (FIDAM) (G.S.), Albert Einstein College of Medicine, New York, New York
| | - Gaetano Santulli
- Department of Medicine, Division of Cardiology, Wilf Family Cardiovascular Research Institute, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Einstein Institute for Aging Research (R.A., S.S.J., G.S.) and Department of Molecular Pharmacology, Institute for Neuroimmunology and Inflammation, Fleischer Institute for Diabetes and Metabolism (FIDAM) (G.S.), Albert Einstein College of Medicine, New York, New York
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19
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Parra-Lucares A, Romero-Hernández E, Villa E, Weitz-Muñoz S, Vizcarra G, Reyes M, Vergara D, Bustamante S, Llancaqueo M, Toro L. New Opportunities in Heart Failure with Preserved Ejection Fraction: From Bench to Bedside… and Back. Biomedicines 2022; 11:70. [PMID: 36672578 PMCID: PMC9856156 DOI: 10.3390/biomedicines11010070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/07/2022] [Accepted: 12/13/2022] [Indexed: 12/29/2022] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) is a growing public health problem in nearly 50% of patients with heart failure. Therefore, research on new strategies for its diagnosis and management has become imperative in recent years. Few drugs have successfully improved clinical outcomes in this population. Therefore, numerous attempts are being made to find new pharmacological interventions that target the main mechanisms responsible for this disease. In recent years, pathological mechanisms such as cardiac fibrosis and inflammation, alterations in calcium handling, NO pathway disturbance, and neurohumoral or mechanic impairment have been evaluated as new pharmacological targets showing promising results in preliminary studies. This review aims to analyze the new strategies and mechanical devices, along with their initial results in pre-clinical and different phases of ongoing clinical trials for HFpEF patients. Understanding new mechanisms to generate interventions will allow us to create methods to prevent the adverse outcomes of this silent pandemic.
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Affiliation(s)
- Alfredo Parra-Lucares
- Critical Care Unit, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago 8380420, Chile
- MD PhD Program, Faculty of Medicine, Universidad de Chile, Santiago 8380420, Chile
| | - Esteban Romero-Hernández
- MD PhD Program, Faculty of Medicine, Universidad de Chile, Santiago 8380420, Chile
- Division of Internal Medicine, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago 8380420, Chile
| | - Eduardo Villa
- School of Medicine, Faculty of Medicine, Universidad de Chile, Santiago 8380420, Chile
| | - Sebastián Weitz-Muñoz
- Division of Internal Medicine, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago 8380420, Chile
| | - Geovana Vizcarra
- Division of Internal Medicine, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago 8380420, Chile
| | - Martín Reyes
- School of Medicine, Faculty of Medicine, Universidad de Chile, Santiago 8380420, Chile
| | - Diego Vergara
- School of Medicine, Faculty of Medicine, Universidad de Chile, Santiago 8380420, Chile
| | - Sergio Bustamante
- Coronary Care Unit, Cardiovascular Department, Hospital Clínico Universidad de Chile, Santiago 8380420, Chile
| | - Marcelo Llancaqueo
- Coronary Care Unit, Cardiovascular Department, Hospital Clínico Universidad de Chile, Santiago 8380420, Chile
| | - Luis Toro
- Division of Nephrology, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago 8380420, Chile
- Centro de Investigación Clínica Avanzada, Hospital Clínico, Universidad de Chile, Santiago 8380420, Chile
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20
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Forzano I, Mone P, Mottola G, Kansakar U, Salemme L, De Luca A, Tesorio T, Varzideh F, Santulli G. Efficacy of the New Inotropic Agent Istaroxime in Acute Heart Failure. J Clin Med 2022; 11:7503. [PMID: 36556120 PMCID: PMC9786901 DOI: 10.3390/jcm11247503] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Current therapeutic strategies for acute heart failure (AHF) are based on traditional inotropic agents that are often associated with untoward effects; therefore, finding new effective approaches with a safer profile is dramatically needed. Istaroxime is a novel compound, chemically unrelated to cardiac glycosides, that is currently being studied for the treatment of AHF. Its effects are essentially related to its inotropic and lusitropic positive properties exerted through a dual mechanism of action: activation of the sarcoplasmic reticulum Ca2+ ATPase isoform 2a (SERCA2a) and inhibition of the Na+/K+-ATPase (NKA) activity. The advantages of istaroxime over the available inotropic agents include its lower arrhythmogenic action combined with its capability of increasing systolic blood pressure without augmenting heart rate. However, it has a limited half-life (1 hour) and is associated with adverse effects including pain at the injection site and gastrointestinal issues. Herein, we describe the main mechanism of action of istaroxime and we present a systematic overview of both clinical and preclinical trials testing this drug, underlining the latest insights regarding its adoption in clinical practice for AHF.
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Affiliation(s)
- Imma Forzano
- Division of Cardiology, Department of Advanced Biomedical Sciences, “Federico II” University, 80131 Naples, Italy
| | - Pasquale Mone
- Division of Cardiology, Department of Medicine, Wilf Family Cardiovascular Research Institute, Einstein Institute for Aging Research, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Gaetano Mottola
- Casa di Cura “Montevergine”, Mercogliano, 83013 Avellino, Italy
| | - Urna Kansakar
- Division of Cardiology, Department of Advanced Biomedical Sciences, “Federico II” University, 80131 Naples, Italy
| | - Luigi Salemme
- Casa di Cura “Montevergine”, Mercogliano, 83013 Avellino, Italy
| | - Antonio De Luca
- Department of Mental and Physical Health and Preventive Medicine, University of Campania “Vanvitelli”, 81100 Caserta, Italy
| | - Tullio Tesorio
- Casa di Cura “Montevergine”, Mercogliano, 83013 Avellino, Italy
| | - Fahimeh Varzideh
- Division of Cardiology, Department of Advanced Biomedical Sciences, “Federico II” University, 80131 Naples, Italy
| | - Gaetano Santulli
- Division of Cardiology, Department of Advanced Biomedical Sciences, “Federico II” University, 80131 Naples, Italy
- Division of Cardiology, Department of Medicine, Wilf Family Cardiovascular Research Institute, Einstein Institute for Aging Research, Albert Einstein College of Medicine, New York, NY 10461, USA
- Department of Molecular Pharmacology, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Einstein Institute for Neuroimmunology and Inflammation (INI), Fleischer Institute for Diabetes and Metabolism (FIDAM), Albert Einstein College of Medicine, New York, NY 10461, USA
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21
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Rupee S, Rupee K, Singh RB, Hanoman C, Ismail AMA, Smail M, Singh J. Diabetes-induced chronic heart failure is due to defects in calcium transporting and regulatory contractile proteins: cellular and molecular evidence. Heart Fail Rev 2022; 28:627-644. [PMID: 36107271 DOI: 10.1007/s10741-022-10271-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 11/04/2022]
Abstract
Heart failure (HF) is a major deteriorating disease of the myocardium due to weak myocardial muscles. As such, the heart is unable to pump blood efficiently around the body to meet its constant demand. HF is a major global health problem with more than 7 million deaths annually worldwide, with some patients dying suddenly due to sudden cardiac death (SCD). There are several risk factors which are associated with HF and SCD which can negatively affect the heart synergistically. One major risk factor is diabetes mellitus (DM) which can cause an elevation in blood glucose level or hyperglycaemia (HG) which, in turn, has an insulting effect on the myocardium. This review attempted to explain the subcellular, cellular and molecular mechanisms and to a lesser extent, the genetic factors associated with the development of diabetes- induced cardiomyopathy due to the HG which can subsequently lead to chronic heart failure (CHF) and SCD. The study first explained the structure and function of the myocardium and then focussed mainly on the excitation-contraction coupling (ECC) processes highlighting the defects of calcium transporting (SERCA, NCX, RyR and connexin) and contractile regulatory (myosin, actin, titin and troponin) proteins. The study also highlighted new therapies and those under development, as well as preventative strategies to either treat or prevent diabetic cardiomyopathy (DCM). It is postulated that prevention is better than cure.
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22
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Luraghi A, Ferrandi M, Barassi P, Arici M, Hsu SC, Torre E, Ronchi C, Romerio A, Chang GJ, Ferrari P, Bianchi G, Zaza A, Rocchetti M, Peri F. Highly Selective SERCA2a Activators: Preclinical Development of a Congeneric Group of First-in-Class Drug Leads against Heart Failure. J Med Chem 2022; 65:7324-7333. [PMID: 35580334 PMCID: PMC9150102 DOI: 10.1021/acs.jmedchem.2c00347] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
![]()
The stimulation of
sarcoplasmic reticulum calcium ATPase SERCA2a
emerged as a novel therapeutic strategy to efficiently improve overall
cardiac function in heart failure (HF) with reduced arrhythmogenic
risk. Istaroxime is a clinical-phase IIb compound with a double mechanism
of action, Na+/K+ ATPase inhibition and SERCA2a
stimulation. Starting from the observation that istaroxime metabolite
PST3093 does not inhibit Na+/K+ ATPase while
stimulates SERCA2a, we synthesized a series of bioisosteric PST3093
analogues devoid of Na+/K+ ATPase inhibitory
activity. Most of them retained SERCA2a stimulatory action with nanomolar
potency in cardiac preparations from healthy guinea pigs and streptozotocin
(STZ)-treated rats. One compound was further characterized in isolated
cardiomyocytes, confirming SERCA2a stimulation and in vivo showing
a safety profile and improvement of cardiac performance following
acute infusion in STZ rats. We identified a new class of selective
SERCA2a activators as first-in-class drug candidates for HF treatment.
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Affiliation(s)
- Andrea Luraghi
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milano 20126, Italy
| | - Mara Ferrandi
- Windtree Therapeutics Inc., Warrington, Pennsylvania 18976, United States
| | - Paolo Barassi
- Windtree Therapeutics Inc., Warrington, Pennsylvania 18976, United States
| | - Martina Arici
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milano 20126, Italy
| | | | - Eleonora Torre
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milano 20126, Italy
| | - Carlotta Ronchi
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milano 20126, Italy
| | - Alessio Romerio
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milano 20126, Italy
| | - Gwo-Jyh Chang
- Cardiovascular Medicine, Chang Gung University, Tao-Yuan 333323 Taiwan
| | - Patrizia Ferrari
- Windtree Therapeutics Inc., Warrington, Pennsylvania 18976, United States
| | - Giuseppe Bianchi
- Windtree Therapeutics Inc., Warrington, Pennsylvania 18976, United States.,Università Vita-Salute San Raffaele, Milano 20132, Italy
| | - Antonio Zaza
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milano 20126, Italy
| | - Marcella Rocchetti
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milano 20126, Italy
| | - Francesco Peri
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milano 20126, Italy
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23
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Wei X, Chang ACH, Chang H, Xu S, Xue Y, Zhang Y, Lei M, Chang ACY, Zhang Q. Hypoglycemia-Exacerbated Mitochondrial Connexin 43 Accumulation Aggravates Cardiac Dysfunction in Diabetic Cardiomyopathy. Front Cardiovasc Med 2022; 9:800185. [PMID: 35369285 PMCID: PMC8967291 DOI: 10.3389/fcvm.2022.800185] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/10/2022] [Indexed: 11/29/2022] Open
Abstract
Background Diabetic cardiomyopathy (DCM) is a complex multifaceted disease responsible for elevated heart failure (HF) morbidity and mortality in patients with diabetes mellitus (DM). Patients with DCM exhibit subclinical diastolic dysfunction, progression toward systolic impairment, and abnormal electrophysiology. Hypoglycemia events that occur spontaneously or due to excess insulin administration threaten the lives of patients with DM—with the increased risk of sudden death. However, the molecular underpinnings of this fatal disease remain to be elucidated. Methods and Results Here, we used the established streptozotocin-induced DCM murine model to investigate how hypoglycemia aggravates DCM progression. We confirmed connexin 43 (Cx43) dissociation from cell–cell interaction and accumulation at mitochondrial inner membrane both in the cardiomyocytes of patients with DM and DCM murine. Here, we observed that cardiac diastolic function, induced by chronic hyperglycemia, was further aggravated upon hypoglycemia challenge. Similar contractile defects were recapitulated using neonatal mouse ventricular myocytes (NMVMs) under glucose fluctuation challenges. Using immunoprecipitation mass spectrometry, we identified and validated that hypoglycemia challenge activates the mitogen-activated protein kinase kinase (MAPK kinase) (MEK)/extracellular regulated protein kinase (ERK) and inhibits phosphoinositide 3-kinase (PI3K)/Akt pathways, which results in Cx43 phosphorylation by Src protein and translocation to mitochondria in cardiomyocytes. To determine causality, we overexpressed a mitochondrial targeting Cx43 (mtCx43) using adeno-associated virus serotype 2 (AAV2)/9. At normal blood glucose levels, mtCx43 overexpression recapitulated cardiac diastolic dysfunction as well as aberrant electrophysiology in vivo. Our findings give support for therapeutic targeting of MEK/ERK/Src and PI3K/Akt/Src pathways to prevent mtCx43-driven DCM. Conclusion DCM presents compensatory adaptation of mild mtCx43 accumulation, yet acute hypoglycemia challenges result in further accumulation of mtCx43 through the MEK/ERK/Src and PI3K/Akt/Src pathways. We provide evidence that Cx43 mislocalization is present in hearts of patients with DM hearts, STZ-induced DCM murine model, and glucose fluctuation challenged NMVMs. Mechanistically, we demonstrated that mtCx43 is responsible for inducing aberrant contraction and disrupts electrophysiology in cardiomyocytes and our results support targeting of mtCx43 in treating DCM.
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Affiliation(s)
- Xing Wei
- Department of Cardiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Andrew Chia Hao Chang
- Shanghai Institute of Precision Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haishuang Chang
- Shanghai Institute of Precision Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shan Xu
- Shanghai Institute of Precision Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yilin Xue
- Shanghai Institute of Precision Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuanxin Zhang
- Department of Cardiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ming Lei
- Shanghai Institute of Precision Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Alex Chia Yu Chang
- Department of Cardiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Precision Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Alex Chia Yu Chang
| | - Qingyong Zhang
- Department of Cardiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Qingyong Zhang
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24
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Kansakar U, Varzideh F, Jankauskas SS, Gambardella J, Trimarco B, Santulli G. Advances in the understanding of excitation-contraction coupling: the pulsing quest for drugs against heart failure and arrhythmias. EUROPEAN HEART JOURNAL. CARDIOVASCULAR PHARMACOTHERAPY 2021; 7:e91-e93. [PMID: 34498676 DOI: 10.1093/ehjcvp/pvab069] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/24/2021] [Accepted: 09/07/2021] [Indexed: 11/14/2022]
Affiliation(s)
- Urna Kansakar
- Departments of Medicine (Cardiology) and Molecular Pharmacology, Einstein College of Medicine, Wilf Family Cardiovascular Research Institute, Einstein-Sinai Diabetes Research Center (ES-DRC), Fleisher Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, 1300 Morris PARK AVENUE, New York City, 10461, NY, USA
| | - Fahimeh Varzideh
- Departments of Medicine (Cardiology) and Molecular Pharmacology, Einstein College of Medicine, Wilf Family Cardiovascular Research Institute, Einstein-Sinai Diabetes Research Center (ES-DRC), Fleisher Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, 1300 Morris PARK AVENUE, New York City, 10461, NY, USA
| | - Stanislovas S Jankauskas
- Departments of Medicine (Cardiology) and Molecular Pharmacology, Einstein College of Medicine, Wilf Family Cardiovascular Research Institute, Einstein-Sinai Diabetes Research Center (ES-DRC), Fleisher Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, 1300 Morris PARK AVENUE, New York City, 10461, NY, USA
| | - Jessica Gambardella
- Departments of Medicine (Cardiology) and Molecular Pharmacology, Einstein College of Medicine, Wilf Family Cardiovascular Research Institute, Einstein-Sinai Diabetes Research Center (ES-DRC), Fleisher Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, 1300 Morris PARK AVENUE, New York City, 10461, NY, USA.,International Translational Research and Medical Education (ITME) Consortium and Department of Advanced Biomedical Sciences, "Federico II" University, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Bruno Trimarco
- International Translational Research and Medical Education (ITME) Consortium and Department of Advanced Biomedical Sciences, "Federico II" University, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Gaetano Santulli
- Departments of Medicine (Cardiology) and Molecular Pharmacology, Einstein College of Medicine, Wilf Family Cardiovascular Research Institute, Einstein-Sinai Diabetes Research Center (ES-DRC), Fleisher Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, 1300 Morris PARK AVENUE, New York City, 10461, NY, USA.,International Translational Research and Medical Education (ITME) Consortium and Department of Advanced Biomedical Sciences, "Federico II" University, Via Sergio Pansini, 5, 80131, Naples, Italy
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