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Natural Activators of Autophagy Increase Maximal Walking Distance and Reduce Oxidative Stress in Patients with Peripheral Artery Disease: A Pilot Study. Antioxidants (Basel) 2022; 11:antiox11091836. [PMID: 36139910 PMCID: PMC9495993 DOI: 10.3390/antiox11091836] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/02/2022] [Accepted: 09/14/2022] [Indexed: 11/29/2022] Open
Abstract
Trehalose, spermidine, nicotinamide, and polyphenols have been shown to display pro-autophagic and antioxidant properties, eventually reducing cardiovascular and ischemic complications. This study aimed to investigate whether a mixture of these components improves maximal walking distance (MWD) in peripheral artery disease (PAD) patients. Nitrite/nitrate (NOx), endothelin-1, sNOX2-dp, H2O2 production, H2O2 break-down activity (HBA), ATG5 and P62 levels, flow-mediated dilation (FMD), and MWD were evaluated in 20 PAD patients randomly allocated to 10.5 g of mixture or no-treatment in a single-blind study. The above variables were assessed at baseline and 60 days after mixture ingestion. Compared with baseline, mixture intake significantly increased MWD (+91%; p < 0.01) and serum NOx (+96%; p < 0.001), whereas it significantly reduced endothelin-1 levels (−30%, p < 0.01). Moreover, mixture intake led to a remarkable reduction in sNOX2dp (−31%, p < 0.05) and H2O2 (−40%, p < 0.001) and potentiated antioxidant power (+110%, p < 0.001). Finally, mixture ingestion restored autophagy by increasing ATG5 (+43%, p < 0.01) and decreasing P62 (−29%, p < 0.05). No changes in the above-mentioned variables were observed in the no-treatment group. The treatment with a mixture of trehalose, spermidine, nicotinamide, and polyphenols improves MWD in PAD patients, with a mechanism possibly related to NOX2-mediated oxidative stress downregulation and autophagic flux upregulation. Clinical Trial Registration unique identifier: NCT04061070.
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Fan H, Zhou J, Huang Y, Feng X, Dang P, Li G, Yuan Z. A Proinflammatory Diet Is Associated with Higher Risk of Peripheral Artery Disease. Nutrients 2022; 14:nu14173490. [PMID: 36079748 PMCID: PMC9460607 DOI: 10.3390/nu14173490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 12/02/2022] Open
Abstract
Peripheral arterial disease (PAD) has a strong relationship with inflammation. However, it is unclear whether the dietary inflammatory potential is associated with PAD. We aimed to address this knowledge gap. The dietary inflammatory index (DII) was obtained using a 24-h dietary recall interview for each individual. Logistic regression models and restricted cubic spline were performed to assess the relationship of DII with the prevalence of PAD. In addition, Spearman correlation analysis and subgroup analysis were also undertaken. In total, 5840 individuals from the 1999–2004 National Health and Nutrition Examination Survey (NHANES) were enrolled in our study. Participants in higher DII quartile tended to have higher rates of PAD. The increase in DII scores showed a positive association with PAD after fully multivariate adjustment (OR (odds ratios) = 1.094, 95% confidence interval (CI): 1.022–1.171). The multivariable-adjusted OR and 95% CI of the highest DII index quartile compared with the lowest quartile was 1.543 (95% CI: 1.116–2.133). Subgroup analysis demonstrated that the positive association between DII and PAD was persistent across population subgroups. In conclusion, we report that a proinflammatory dietary pattern is related to a higher risk of developing PAD among US adults.
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Affiliation(s)
- Heze Fan
- Cardiovascular Department, First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an 710061, China
- Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an 710061, China
| | - Juan Zhou
- Cardiovascular Department, First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an 710061, China
- Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an 710061, China
| | - Yuzhi Huang
- Cardiovascular Department, First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an 710061, China
- Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an 710061, China
| | - Xueying Feng
- Cardiovascular Department, First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an 710061, China
- Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an 710061, China
| | - Peizhu Dang
- Cardiovascular Department, First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an 710061, China
- Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an 710061, China
| | - Guoliang Li
- Cardiovascular Department, First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an 710061, China
- Correspondence: (G.L.); (Z.Y.)
| | - Zuyi Yuan
- Cardiovascular Department, First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an 710061, China
- Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an 710061, China
- Correspondence: (G.L.); (Z.Y.)
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Adesse D, Gladulich L, Alvarez-Rosa L, Siqueira M, Marcos AC, Heider M, Motta CS, Torices S, Toborek M, Stipursky J. Role of aging in Blood-Brain Barrier dysfunction and susceptibility to SARS-CoV-2 infection: impacts on neurological symptoms of COVID-19. Fluids Barriers CNS 2022; 19:63. [PMID: 35982454 PMCID: PMC9386676 DOI: 10.1186/s12987-022-00357-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 07/18/2022] [Indexed: 12/21/2022] Open
Abstract
COVID-19, which is caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), has resulted in devastating morbidity and mortality worldwide due to lethal pneumonia and respiratory distress. In addition, the central nervous system (CNS) is well documented to be a target of SARS-CoV-2, and studies detected SARS-CoV-2 in the brain and the cerebrospinal fluid of COVID-19 patients. The blood-brain barrier (BBB) was suggested to be the major route of SARS-CoV-2 infection of the brain. Functionally, the BBB is created by an interactome between endothelial cells, pericytes, astrocytes, microglia, and neurons, which form the neurovascular units (NVU). However, at present, the interactions of SARS-CoV-2 with the NVU and the outcomes of this process are largely unknown. Moreover, age was described as one of the most prominent risk factors for hospitalization and deaths, along with other comorbidities such as diabetes and co-infections. This review will discuss the impact of SARS-CoV-2 on the NVU, the expression profile of SARS-CoV-2 receptors in the different cell types of the CNS and the possible role of aging in the neurological outcomes of COVID-19. A special emphasis will be placed on mitochondrial functions because dysfunctional mitochondria are also a strong inducer of inflammatory reactions and the "cytokine storm" associated with SARS-CoV-2 infection. Finally, we will discuss possible drug therapies to treat neural endothelial function in aged patients, and, thus, alleviate the neurological symptoms associated with COVID-19.
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Affiliation(s)
- Daniel Adesse
- Laboratório de Biologia Estrutural, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil, 4365, Pavilhão Carlos Chagas, sala 307b, Rio de Janeiro, RJ, 21040-360, Brazil.
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
| | - Luis Gladulich
- Laboratório de Biologia Estrutural, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil, 4365, Pavilhão Carlos Chagas, sala 307b, Rio de Janeiro, RJ, 21040-360, Brazil
| | - Liandra Alvarez-Rosa
- Laboratório de Biologia Estrutural, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil, 4365, Pavilhão Carlos Chagas, sala 307b, Rio de Janeiro, RJ, 21040-360, Brazil
- Laboratório Compartilhado, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Michele Siqueira
- Laboratório Compartilhado, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Anne Caroline Marcos
- Laboratório de Biologia Estrutural, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil, 4365, Pavilhão Carlos Chagas, sala 307b, Rio de Janeiro, RJ, 21040-360, Brazil
| | - Marialice Heider
- Laboratório de Biologia Estrutural, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil, 4365, Pavilhão Carlos Chagas, sala 307b, Rio de Janeiro, RJ, 21040-360, Brazil
| | - Caroline Soares Motta
- Laboratório de Biologia Estrutural, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil, 4365, Pavilhão Carlos Chagas, sala 307b, Rio de Janeiro, RJ, 21040-360, Brazil
| | - Silvia Torices
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Michal Toborek
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
- Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Joice Stipursky
- Laboratório Compartilhado, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Peñín-Grandes S, Martín-Hernández J, Valenzuela PL, López-Ortiz S, Pinto-Fraga J, Solá LDR, Emanuele E, Lista S, Lucia A, Santos-Lozano A. Exercise and the hallmarks of peripheral arterial disease. Atherosclerosis 2022; 350:41-50. [DOI: 10.1016/j.atherosclerosis.2022.04.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/06/2022] [Accepted: 04/21/2022] [Indexed: 01/08/2023]
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Ismaeel A, Lavado R, Koutakis P. Metabolomics of peripheral artery disease. Adv Clin Chem 2022; 106:67-89. [PMID: 35152975 DOI: 10.1016/bs.acc.2021.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The science of metabolomics has emerged as a novel tool for studying changes in metabolism that accompany different disease states. Several studies have applied this evolving field to the study of various cardiovascular disease states, which has led to improved understanding of metabolic changes that underlie heart failure and ischemic heart disease. A significant amount of progress has also been made in the identification of novel biomarkers of cardiovascular disease. Another common atherosclerotic disease, peripheral artery disease (PAD) affects arteries of the lower extremities. Although certain aspects of the disease pathophysiology overlap with other cardiovascular diseases in general, PAD patients suffer unique manifestations that lead to significant morbidity and mortality as well as severe functional limitations. Furthermore, because over half of PAD patients are asymptomatic, there is a need for improved diagnostic and screening methods. Identification of metabolites associated with the disease may thus be a promising approach for PAD. However, PAD remains highly understudied. In this chapter, we discuss the application of metabolomics to the study of PAD.
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Affiliation(s)
- Ahmed Ismaeel
- Department of Biology, Baylor University, Waco, TX, United States
| | - Ramon Lavado
- Department of Environmental Science, Baylor University, Waco, TX, United States
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Ismaeel A, Miserlis D, Papoutsi E, Haynatzki G, Bohannon WT, Smith RS, Eidson JL, Casale GP, Pipinos II, Koutakis P. Endothelial cell-derived pro-fibrotic factors increase TGF-β1 expression by smooth muscle cells in response to cycles of hypoxia-hyperoxia. Biochim Biophys Acta Mol Basis Dis 2022; 1868:166278. [PMID: 34601016 PMCID: PMC8629962 DOI: 10.1016/j.bbadis.2021.166278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/12/2021] [Accepted: 09/23/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND The vascular pathology of peripheral artery disease (PAD) encompasses abnormal microvascular architecture and fibrosis in response to ischemia-reperfusion (I/R) cycles. We aimed to investigate the mechanisms by which pathological changes in the microvasculature direct fibrosis in the context of I/R. METHODS Primary human aortic endothelial cells (ECs) were cultured under cycles of normoxia-hypoxia (NH) or normoxia-hypoxia-hyperoxia (NHH) to mimic I/R. Primary human aortic smooth muscle cells (SMCs) were cultured and treated with media from the ECs. FINDINGS The mRNA and protein expression of the pro-fibrotic factors platelet derived growth factor (PDGF)-BB and connective tissue growth factor (CTGF) were significantly upregulated in ECs undergoing NH or NHH cycles. Treatment of SMCs with media from ECs undergoing NH or NHH cycles led to significant increases in TGF-β1, TGF-β pathway signaling intermediates, and collagen expression. Addition of neutralizing antibodies against PDGF-BB and CTGF to the media blunted the increases in TGF-β1 and collagen expression. Treatment of SMCs with PAD patient-derived serum also led to increased TGF-β1 levels. INTERPRETATION In an in-vitro model of I/R, which recapitulates the pathophysiology of PAD, increased secretion of PDGF-BB and CTGF by ECs was shown to be predominantly driving TGF-β1-mediated expression by SMCs. These cell culture experiments help elucidate the mechanism and interaction between ECs and SMCs in microvascular fibrosis associated with I/R. Thus, targeting these pro-fibrotic factors may be an effective strategy to combat fibrosis in response to cycles of I/R. FUNDING National Institute on Aging at the National Institutes of Health grant number R01AG064420. RESEARCH IN CONTEXT Evidence before this study: Previous studies in gastrocnemius biopsies from peripheral artery disease (PAD) patients showed that transforming growth factor beta 1 (TGF-β1), the most potent inducer of pathological fibrosis, is increased in the vasculature of PAD patients and correlated with collagen deposition. However, the exact cellular source of TGF-β1 remained unclear. Added value of this study: Exposing cells to cycles of normoxia-hypoxia-hyperoxia (NHH) resulted in pathological changes that are consistent with human PAD. This supports the idea that the use of NHH may be a reliable, novel in vitro model of PAD useful for studying associated pathophysiological mechanisms. Furthermore, pro-fibrotic factors (PDGF-BB and CTGF) released from endothelial cells were shown to induce a fibrotic phenotype in smooth muscle cells. This suggests a potential interaction between these cell types in the microvasculature that drives increased TGF-β1 expression and collagen deposition. Thus, targeting these pro-fibrotic factors may be an effective strategy to combat fibrosis in response to cycles of ischemia-reperfusion.
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Affiliation(s)
- Ahmed Ismaeel
- Department of Biology, Baylor University, B.207 Baylor Science Building, One Bear Place #97388, Waco, TX 76798-7388, USA
| | - Dimitrios Miserlis
- Department of Surgery, University of Texas Health Science Center San Antonio, 8300 Floyd Curl Dr., San Antonio, TX 78229, USA
| | - Evlampia Papoutsi
- Department of Biology, Baylor University, B.207 Baylor Science Building, One Bear Place #97388, Waco, TX 76798-7388, USA
| | - Gleb Haynatzki
- Department of Biostatistics, University of Nebraska Medical Center, 984375 Nebraska Medical Center, Omaha, NE 68198-4375, USA
| | - William T Bohannon
- Department of Surgery, Baylor Scott & White Medical Center, 2401 S 31st St, Temple, TX 76508, USA
| | - Robert S Smith
- Department of Surgery, Baylor Scott & White Medical Center, 2401 S 31st St, Temple, TX 76508, USA
| | - Jack L Eidson
- Department of Surgery, Baylor Scott & White Medical Center, 2401 S 31st St, Temple, TX 76508, USA
| | - George P Casale
- Department of Surgery, University of Nebraska Medical Center, 982500 Nebraska Medical Center, Omaha, NE 68198-2500, USA
| | - Iraklis I Pipinos
- Department of Surgery, University of Nebraska Medical Center, 982500 Nebraska Medical Center, Omaha, NE 68198-2500, USA
| | - Panagiotis Koutakis
- Department of Biology, Baylor University, B.207 Baylor Science Building, One Bear Place #97388, Waco, TX 76798-7388, USA.
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Loffredo L, Ben MD, Bartimoccia S, Castellani V, Mancinella M, Ciacci P, Orlando F, Paraninfi A, Angelico F, Ferro D, Cammisotto V, Carnevale R. Chocolate enriched by extra virgin olive oil improves endothelial function and oxidative stress in patients with diabetes. Nutrition 2021; 90:111270. [PMID: 34010747 DOI: 10.1016/j.nut.2021.111270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/20/2021] [Accepted: 03/29/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Endothelial dysfunction and oxidative stress are among the most relevant mechanisms underlying the atherosclerotic process in patients with type 2 diabetes mellitus (T2 DM). Extra virgin olive oil (EVOO) reduces postprandial glycemia with a mechanism counteracting oxidative stress-mediated incretin down-regulation in healthy subjects and in patients with impaired fasting glucose. The aim of this study was to evaluate if the intake of chocolate enriched by EVOO had positive effects on endothelial function and oxidative stress in patients with T2 DM. METHODS In this study we enrolled and randomly assigned 25 consecutive patients with T2 DM to receive 40 g of EVOO-enriched chocolate or 40 g of control chocolate spread. Participants were assessed at baseline and 2 h after chocolate intake. Endothelial function was assessed by arterial brachial flow-mediated dilation (FMD); oxidative stress was evaluated by the measurement of serum nicotinamide adenine dinucleotide phosphate (NADPH) oxidase-2 (Nox2) levels, nitric oxide availability, and serum hydrogen peroxide breakdown activity (HBA). RESULTS We observed a significant increase of FMD, nitric oxide (NO) availability, and HBA in the EVOO-enriched chocolate group (P < 0.001). Conversely, soluble Nox2-derived peptide (sNox2-dp) levels significantly decreased (P < 0.001). No significant change was observed in the control chocolate group. To assess the relation of EVOO-enriched chocolate to endothelial function and oxidative stress, a general linear model (GLM) analysis was performed; a significant difference for treatments was found with respect to FMD, NO availability, HBA, and sNox-dp. CONCLUSIONS Administration of 40 g of EVOO-enriched chocolate is associated with increased endothelial function and reduction of oxidative stress in patients with T2 DM. Future studies are needed to analyze the effect of chronic assumption of EVOO-enriched chocolate on vascular function, oxidative stress, and cardiovascular complications in patients with T2 DM.
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Affiliation(s)
- Lorenzo Loffredo
- Department of Clinical Internal, Anesthesiologic, and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Del Ben
- Department of Clinical Internal, Anesthesiologic, and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Simona Bartimoccia
- Department of Clinical Internal, Anesthesiologic, and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Valentina Castellani
- Department of Clinical Internal, Anesthesiologic, and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Paolo Ciacci
- Department of Clinical Internal, Anesthesiologic, and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Federica Orlando
- Department of Clinical Internal, Anesthesiologic, and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Aurora Paraninfi
- Department of Clinical Internal, Anesthesiologic, and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesco Angelico
- Department of Clinical Internal, Anesthesiologic, and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Domenico Ferro
- Department of Clinical Internal, Anesthesiologic, and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Vittoria Cammisotto
- Department of Clinical Internal, Anesthesiologic, and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy; Department of General Surgery and Surgical Speciality Paride Stefanini, Sapienza University of Rome, Rome, Italy
| | - Roberto Carnevale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Mediterranea Cardiocentro, Napoli, Italy.
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Abstract
Among all peripheral arterial diseases, lower extremity arterial disease is a serious condition in subjects with type 2 diabetes mellitus, associated with important disability, cardiovascular risk, and socio-economic burden. Patients with both conditions generally display poorer prognosis of affected limbs compared with non-diabetic subjects, leading to increased rates of adverse limb events including amputations. Nonetheless, awareness on lower extremity arterial disease remains somehow suboptimal in the diabetic population, partly related to an atypical clinical presentation in several cases. A regular and appropriate screening for lower extremity arterial disease in patients suffering from type 2 diabetes mellitus is therefore recommended. Affected subjects should receive optimal medical treatment including careful management of the different cardiovascular risk factors through a healthy lifestyle, a regular and structured physical activity, the administration of lipid-lowering, antidiabetic drugs, and (when indicated) antihypertensive and antithrombotic drugs. This review aims to outline current evidence about lower extremity arterial disease in patients with type 2 diabetes mellitus, in order to elucidate its epidemiology, pathophysiology, screening and diagnosis, and management options.
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Affiliation(s)
- Giacomo Buso
- Department of Angiology, Centre hospitalier universitaire vaudois, Switzerland
| | - Victor Aboyans
- Department of Cardiology, Dupuytren University Hospital, France.,Inserm 1098, School of Medicine, France
| | - Lucia Mazzolai
- Department of Angiology, Centre hospitalier universitaire vaudois, Switzerland
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Korkmaz UTK, Yuksel A, Cetinkaya A, Velioglu Y, Ucaroglu ER, Cayir MC, Kumtepe G, Borulu F, Bal C, Erdem K, Gok G, Devay SD. Dynamic thiol/disulphide homeostasis metrics as a risk factor for peripheral arterial disease. Vascular 2020; 29:248-255. [PMID: 32772842 DOI: 10.1177/1708538120947245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine dynamic thiol/disulphide homeostasis metrics as a novel risk factor of oxidative stress in patients with peripheral arterial disease. METHODS One hundred patients with lower extremity peripheral arterial disease (a study group) and 100 control subjects were included in this prospective case-control study. Participants' baseline clinical characteristics and laboratory data including some oxidant/antioxidant status parameters such as albumin, ferroxidase and myeloperoxidase, and thiol/disulphide homeostasis parameters such as native thiol, total thiol and disulphide, as well as native thiol/total thiol, disulphide/native thiol and disulphide/total thiol ratios were all recorded and then compared between the groups. RESULTS Mean albumin and ferroxidase, and median myeloperoxidase levels were found to be significantly higher in patients with the peripheral arterial disease than in control group (p = 0.045, p = 0.000 and p = 0.000, respectively). Mean native thiol and total thiol, and median disulphide levels were found to be significantly lower in the study group as compared with the control group (p = 0.000, p = 0.000 and p = 0.037, respectively). According to the results of logistic regression analysis, systolic blood pressure, ferroxidase and myeloperoxidase levels were detected to be the independent predictors of peripheral arterial disease. CONCLUSION Our report is the first one in the literature investigating dynamic thiol/disulphide homeostasis metrics as a novel risk factor of oxidative stress in peripheral arterial disease. Dynamic thiol/disulphide homeostasis metrics may be used as a valuable risk factor of oxidative stress in patients with the peripheral arterial disease since it is readily available, easily calculated and relatively cheap.
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Affiliation(s)
- Ufuk Turan Kursat Korkmaz
- Department of Cardiovascular Surgery, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - Ahmet Yuksel
- Department of Cardiovascular Surgery, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - Ayhan Cetinkaya
- Department of Physiology, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - Yusuf Velioglu
- Department of Cardiovascular Surgery, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - Erhan Renan Ucaroglu
- Department of Cardiovascular Surgery, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - Mustafa Cagdas Cayir
- Department of Cardiovascular Surgery, Pamukkale University, Faculty of Medicine, Denizli, Turkey
| | - Gencehan Kumtepe
- Department of Cardiovascular Surgery, Isparta City Hospital, Isparta, Turkey
| | - Ferhat Borulu
- Department of Cardiovascular Surgery, Ataturk University, Faculty of Medicine, Erzurum, Turkey
| | - Ceylan Bal
- Department of Biochemistry, Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey
| | - Kemalettin Erdem
- Department of Cardiovascular Surgery, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - Gamze Gok
- Department of Biochemistry, Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey
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The Nitric Oxide System in Peripheral Artery Disease: Connection with Oxidative Stress and Biopterins. Antioxidants (Basel) 2020; 9:antiox9070590. [PMID: 32640613 PMCID: PMC7402092 DOI: 10.3390/antiox9070590] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/15/2020] [Accepted: 07/01/2020] [Indexed: 02/06/2023] Open
Abstract
Peripheral artery disease (PAD) pathophysiology extends beyond hemodynamics to include other operating mechanisms, including endothelial dysfunction. Oxidative stress may be linked to endothelial dysfunction by reducing nitric oxide (NO) bioavailability. We aimed to investigate whether the NO system and its regulators are altered in the setting of PAD and to assess the relationship between NO bioavailability and oxidative stress. Sera from 35 patients with intermittent claudication (IC), 26 patients with critical limb ischemia (CLI), and 35 non-PAD controls were analyzed to determine levels of tetrahydrobiopterin (BH4), dihydrobiopterin (BH2), nitrate/nitrite (nitric oxides, or NOx), arginine, citrulline, asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and the oxidative stress markers 8-Oxo-2′-deoxyguanosine (8-OHdG), 4-hydroxynonenal (4-HNE), advanced glycation end products (AGEs), and protein carbonyls. NOx was significantly lower in IC and CLI patients compared to controls in association with elevated oxidative stress, with the greatest NOx reductions observed in CLI. Compared with controls, IC and CLI patients had reduced BH4, elevated BH2, and a reduced BH4/BH2 ratio. SDMA, the arginine/SDMA ratio, and the arginine/ADMA ratio were significantly higher in CLI patients. The NO system and its regulators are significantly compromised in PAD. This dysregulation appears to be driven by increased oxidative stress and worsens as the disease progresses from claudication to CLI.
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Signorelli SS, Marino E, Scuto S, Di Raimondo D. Pathophysiology of Peripheral Arterial Disease (PAD): A Review on Oxidative Disorders. Int J Mol Sci 2020; 21:ijms21124393. [PMID: 32575692 PMCID: PMC7352779 DOI: 10.3390/ijms21124393] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/13/2020] [Accepted: 06/18/2020] [Indexed: 12/14/2022] Open
Abstract
Peripheral arterial disease (PAD) is an atherosclerotic disease that affects a wide range of the world’s population, reaching up to 200 million individuals worldwide. PAD particularly affects elderly individuals (>65 years old). PAD is often underdiagnosed or underestimated, although specificity in diagnosis is shown by an ankle/brachial approach, and the high cardiovascular event risk that affected the PAD patients. A number of pathophysiologic pathways operate in chronic arterial ischemia of lower limbs, giving the possibility to improve therapeutic strategies and the outcome of patients. This review aims to provide a well detailed description of such fundamental issues as physical exercise, biochemistry of physical exercise, skeletal muscle in PAD, heme oxygenase 1 (HO-1) in PAD, and antioxidants in PAD. These issues are closely related to the oxidative stress in PAD. We want to draw attention to the pathophysiologic pathways that are considered to be beneficial in order to achieve more effective options to treat PAD patients.
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Affiliation(s)
- Salvatore Santo Signorelli
- Department of Clinical and Experimental Medicine, University of Catania, 95125 Catania, Italy; (E.M.); (S.S.)
- Correspondence: ; Tel.: +39-09-5378-2545
| | - Elisa Marino
- Department of Clinical and Experimental Medicine, University of Catania, 95125 Catania, Italy; (E.M.); (S.S.)
| | - Salvatore Scuto
- Department of Clinical and Experimental Medicine, University of Catania, 95125 Catania, Italy; (E.M.); (S.S.)
| | - Domenico Di Raimondo
- Division of Internal Medicine and Stroke Care, Department of Promoting Health, Maternal-Infant. Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, University of Palermo, 90127 Palermo, Italy;
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12
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Shafe O, Moosavi J, Shishehbor MH, Sedigh H, Bakhshandeh H, Mahboubian F, Alilou S, Rafatnia S, Sadeghipour P. Effect of drug-coated balloons versus bare-metal stents on endothelial function in patients with severe lower limb peripheral artery disease. Vascular 2020; 28:548-556. [PMID: 32338153 DOI: 10.1177/1708538120921316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Research shows impaired endothelial function in patients with vascular diseases and improved endothelial function following revascularization and medical treatment. There is, however, a dearth of data on the effects of different endovascular therapeutic strategies on endothelial function. We sought to compare the effects of two endovascular strategies of drug-coated balloons versus stenting on endothelial function. METHODS The reactive hyperemia index, the ankle-brachial index, and the toe-brachial index were measured in patients undergoing endovascular revascularization preprocedurally and on the 90th postprocedural day. After adjusting for baseline line characteristics, reactive hyperemia index were compared between the two groups at baseline and at 90 days. RESULTS Between January 2018 and March 2019, 86 patients were prospectively included in a non-randomized manner. Drug-coated ballooning alone was carried out on 46 patients, and bailout stenting after plain balloon angioplasty was performed on the remaining 40 patients The post-revascularization reactive hyperemia index exhibited a significant rise in both groups (1.58 ± 0.21 vs. 1.43 ± 0.20; P = 0.0001). There was no difference in the postprocedural reactive hyperemia index between the two treatment groups. Additionally, the follow-up reactive hyperemia index showed no significant change compared with the postprocedural reactive hyperemia index (1.58 ± 0.23 vs. 1.57 ± 0.22). The results of subgroup analysis between a group of clinically high-risk patients and a group of patients with complex lesions were similar to the aforementioned results. CONCLUSIONS The reactive hyperemia index was significantly improved by endovascular therapy in our study population. However, no difference was observed between drug-coated ballooning and bare-metal stenting, which highlights the effects of vessel patency on endothelial function.
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Affiliation(s)
- Omid Shafe
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Jamal Moosavi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi H Shishehbor
- University Hospitals, Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Hamid Sedigh
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hooman Bakhshandeh
- Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farzane Mahboubian
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sanam Alilou
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shirin Rafatnia
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Parham Sadeghipour
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
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13
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Murai Y, Sasase T, Tadaki H, Heitaku S, Imagawa N, Yamada T, Ohta T. Analysis of haemodynamics and angiogenic response to ischaemia in the obese type 2 diabetic model Spontaneously Diabetic Torii
Lepr
fa
(SDT fatty) rats. Clin Exp Pharmacol Physiol 2020; 47:583-590. [DOI: 10.1111/1440-1681.13239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 12/14/2019] [Accepted: 12/15/2019] [Indexed: 01/14/2023]
Affiliation(s)
- Yasutaka Murai
- Japan Tobacco Inc. Central Pharmaceutical Research Institute Takatsuki Osaka Japan
- Faculty of Agriculture Department of Agrobiology Niigata University Niigata Japan
| | - Tomohiko Sasase
- Japan Tobacco Inc. Central Pharmaceutical Research Institute Takatsuki Osaka Japan
| | - Hironobu Tadaki
- Japan Tobacco Inc. Central Pharmaceutical Research Institute Takatsuki Osaka Japan
| | - Shiro Heitaku
- Japan Tobacco Inc. Central Pharmaceutical Research Institute Takatsuki Osaka Japan
| | - Naoya Imagawa
- Japan Tobacco Inc. Central Pharmaceutical Research Institute Takatsuki Osaka Japan
| | - Takahisa Yamada
- Faculty of Agriculture Department of Agrobiology Niigata University Niigata Japan
| | - Takeshi Ohta
- Laboratory of Animal Physiology and Functional Anatomy Graduate School of Agriculture Kyoto University Kitashirakawa Kyoto Japan
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14
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Talari HR, Azad ZJ, Hamidian Y, Samimi M, Gilasi HR, Ebrahimi Afshar F, Ostadmohammadi V, Asemi Z. Effects of Carnitine Administration on Carotid Intima-media Thickness and Inflammatory Factors in Patients with Polycystic Ovary Syndrome: A Randomized, Double-blind, Placebo-controlled Trial. Int J Prev Med 2019; 10:89. [PMID: 31360336 PMCID: PMC6592103 DOI: 10.4103/ijpvm.ijpvm_2_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 02/26/2018] [Indexed: 12/04/2022] Open
Abstract
Background: This study was performed to evaluate the effects of carnitine administration on carotid intima-media thickness (CIMT) and inflammatory markers in women with polycystic ovary syndrome (PCOS). Methods: This randomized, double-blind, placebo-controlled trial was conducted among 60 women diagnosed with PCOS according to the Rotterdam criteria, aged 18–40 years. Participants were randomly allocated into two groups to intake either 250 mg/day carnitine (n = 30) or placebo (n = 30) for 12 weeks. High-resolution carotid ultrasonography was conducted at baseline and after the 12-week intervention. Results: After the 12-week intervention, compared with the placebo, carnitine supplementation resulted in a significant decrease in maximum levels of the left CIMT (−0.01 ± 0.02 vs. +0.002 mm ± 0.006 mm, P = 0.001), mean levels of the left CIMT (−0.01 ± 0.02 vs. +0.001 mm ± 0.01 mm, P = 0.001), maximum levels of the right CIMT (−0.01 ± 0.02 vs. +0.006 mm ± 0.01 mm, P < 0.001), and mean levels of the right CIMT (−0.01 ± 0.02 vs. +0.002 mm ± 0.01 mm, P = 0.001). Change in plasma nitric oxide (NO) (+2.4 ± 3.6 vs. +0.2 ± 2.3 μmol/L, P = 0.007) was significantly different between the supplemented patients and placebo group. We did not see any significant effect in serum high sensitivity C-reactive protein (hs-CRP) following the supplementation of carnitine compared with the placebo. Conclusions: Overall, carnitine administration for 12 weeks to participants with PCOS had beneficial effects on CIMT and plasma NO, but did not affect serum hs-CRP levels.
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Affiliation(s)
- Hamid Reza Talari
- Department of Radiology, Kashan University of Medical Sciences, Kashan, Iran
| | - Zeinab Jafari Azad
- Department of Radiology, Kashan University of Medical Sciences, Kashan, Iran
| | - Yaser Hamidian
- Department of Radiology, Kashan University of Medical Sciences, Kashan, Iran
| | - Mansooreh Samimi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamid Reza Gilasi
- Department of Epidemiology and Biostatistics, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Faraneh Ebrahimi Afshar
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Vahidreza Ostadmohammadi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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15
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Biondi‐Zoccai G, Sciarretta S, Bullen C, Nocella C, Violi F, Loffredo L, Pignatelli P, Perri L, Peruzzi M, Marullo AG, De Falco E, Chimenti I, Cammisotto V, Valenti V, Coluzzi F, Cavarretta E, Carrizzo A, Prati F, Carnevale R, Frati G. Acute Effects of Heat-Not-Burn, Electronic Vaping, and Traditional Tobacco Combustion Cigarettes: The Sapienza University of Rome-Vascular Assessment of Proatherosclerotic Effects of Smoking ( SUR - VAPES ) 2 Randomized Trial. J Am Heart Assoc 2019; 8:e010455. [PMID: 30879375 PMCID: PMC6475061 DOI: 10.1161/jaha.118.010455] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 12/18/2018] [Indexed: 02/05/2023]
Abstract
Background Little clinical research on new-generation heat-not-burn cigarettes ( HNBC ) in comparison with electronic vaping cigarettes ( EVC ) and traditional tobacco combustion cigarettes ( TC ) has been reported. We aimed to appraise the acute effects of single use of HNBC , EVC, and TC in healthy smokers. Methods and Results This was an independent, cross-over, randomized trial in 20 TC smokers, with allocation to different cycles of HNBC , EVC , and TC . All participants used all types of products, with an intercycle washout of 1 week. End points were oxidative stress, antioxidant reserve, platelet activation, flow-mediated dilation, blood pressure, and satisfaction scores. Single use of any product led to an adverse impact on oxidative stress, antioxidant reserve, platelet function, flow-mediated dilation, and blood pressure. HNBC had less impact than EVC and TC on soluble Nox2-derived peptide (respectively, P=0.004 and 0.001), 8-iso-prostaglandin F2α- III ( P=0.004 and <0.001), and vitamin E ( P=0.018 and 0.044). HNBC and EVC were equally less impactful than TCs on flow-mediated dilation ( P=0.872 for HNBC versus EVC ), H2O2 ( P=0.522), H2O2 breakdown activity ( P=0.091), soluble CD 40 ligand ( P=0.849), and soluble P-selectin ( P=0.821). The effect of HNBC and, to a lesser extent EVC , on blood pressure was less evident than that of TC , whereas HNBC appeared more satisfying than EVC (all P<0.05). Conclusions Acute effects of HNBC , EVC, and TC are different on several oxidative stress, antioxidant reserve, platelet function, cardiovascular, and satisfaction dimensions, with TCs showing the most detrimental changes in clinically relevant features. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 03301129.
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Affiliation(s)
- Giuseppe Biondi‐Zoccai
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
- IRCCS NEUROMEDPozzilliItaly
| | - Sebastiano Sciarretta
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
- IRCCS NEUROMEDPozzilliItaly
| | - Christopher Bullen
- National Institute for Health InnovationSchool of Population HealthFaculty of Medical and Health SciencesThe University of AucklandNew Zealand
| | | | - Francesco Violi
- Department of Internal Medicine and Medical SpecialtiesSapienza University of RomeItaly
| | - Lorenzo Loffredo
- Department of Internal Medicine and Medical SpecialtiesSapienza University of RomeItaly
| | - Pasquale Pignatelli
- Department of Internal Medicine and Medical SpecialtiesSapienza University of RomeItaly
| | - Ludovica Perri
- Department of Internal Medicine and Medical SpecialtiesSapienza University of RomeItaly
| | - Mariangela Peruzzi
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | - Antonino G.M. Marullo
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | - Elena De Falco
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | - Isotta Chimenti
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | - Vittoria Cammisotto
- Department of Internal Medicine and Medical SpecialtiesSapienza University of RomeItaly
| | - Valentina Valenti
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | - Flaminia Coluzzi
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | - Elena Cavarretta
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | | | - Francesco Prati
- Division of CardiologySan Giovanni Addolorata HospitalRomeItaly
- Centro Per La Lotta Contro L'InfartoRomeItaly
| | - Roberto Carnevale
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | - Giacomo Frati
- IRCCS NEUROMEDPozzilliItaly
- National Institute for Health InnovationSchool of Population HealthFaculty of Medical and Health SciencesThe University of AucklandNew Zealand
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16
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Loffredo L, Perri L, Battaglia S, Nocella C, Menichelli D, Cammisotto V, Novo M, Carnevale R, Violi F. Hazelnut and cocoa spread improves flow-mediated dilatation in smokers. Intern Emerg Med 2018; 13:1211-1217. [PMID: 30030699 DOI: 10.1007/s11739-018-1913-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 07/12/2018] [Indexed: 10/28/2022]
Abstract
Hazelnut and cocoa spread is an Italian product containing cocoa and hazelnut. Several epidemiological studies suggest that cocoa and hazelnuts cocoa exert beneficial cardiovascular effects. To investigate whether in smokers, hazelnut and cocoa spread elicits artery dilatation via down-regulation of oxidative stress. Flow-mediated dilatation (FMD), oxidative stress (as assessed by serum isoprostanes excretion, Nox2 activation and NO bioavailability) and antioxidant status [as assessed by vitamin E levels, plasma total polyphenols and H2O2 breaking down activity (HBA)] were studied in 20 smokers in a crossover, single-blind study. Patients were randomly allocated to 60 g of Hazelnut and cocoa spread or 60 g of milk chocolate (≤ 35% cocoa). FMD, serum isoprostanes, Nox2 activation, NOx, vitamin E, HBA and total polyphenols were assessed at baseline and 2 h after chocolate ingestion. After Hazelnut and cocoa spread intake, FMD and NOx significantly increased (from 4.3 ± 2.8 to 8.0 ± 3.2%, p < 0.001 and from 23.1 ± 5.5 to 32.0 ± 12.6 µM, p = 0.016, respectively); conversely, serum isoprostanes and Nox2 activation significantly decreased (from 302.8 ± 59.8 to 240.7 ± 90.8 pmol/l, p = 0.03 and from 25 ± 4.4 to 22.6 ± 3.2, p = 0.03, respectively). After Hazelnut and cocoa spread intake, serum total polyphenols, vitamin E and HBA significantly increased (from 133.8 ± 49.7 to 202.5 ± 69.5 mg/l GAE, p = 0.001; from 3.56 ± 1.4 to 4.5 ± 1.0 μmol/mmol cholesterol, p = 0.002 and from 63.3 ± 13.2 to 74.2 ± 12.4%, p = 0.003, respectively). No changes in the above variables were observed after milk chocolate intake. A linear correlation analysis shows that Δ (expressed by difference of values between before and after chocolate intake) of FMD correlates with Δ of total polyphenols and Δ of vitamin E. This study shows that Hazelnut and cocoa spread improves FMD with a mechanism potentially involving downregulation of oxidative stress and eventually increased NO generation in smokers.
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Affiliation(s)
- Lorenzo Loffredo
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Ludovica Perri
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Simona Battaglia
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Cristina Nocella
- Department of AngioCardioNeurology, IRCCS NeuroMed, 86077, Pozzilli, IS, Italy
| | - Danilo Menichelli
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Vittoria Cammisotto
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Marta Novo
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Roberto Carnevale
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Francesco Violi
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
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17
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Loffredo L, Zicari AM, Occasi F, Perri L, Carnevale R, Battaglia S, Angelico F, Del Ben M, Martino F, Nocella C, Farcomeni A, De Castro G, Duse M, Violi F. Passive Smoking Exacerbates Nicotinamide-Adenine Dinucleotide Phosphate Oxidase Isoform 2-Induced Oxidative Stress and Arterial Dysfunction in Children with Persistent Allergic Rhinitis. J Pediatr 2018; 202:252-257. [PMID: 30172425 DOI: 10.1016/j.jpeds.2018.06.053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/14/2018] [Accepted: 06/18/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To characterize nicotinamide-adenine dinucleotide phosphate oxidase isoform 2 (NOX2), oxidative stress, and endothelial function in children with and without allergic rhinitis and to ascertain the effect of passive smoke exposure on these factors, because there is an established association between allergic rhinitis and increased cardiovascular risk in adults. METHODS We recruited 130 children-65 with persistent allergic rhinitis and 65 healthy controls. A cross-sectional study was performed to compare endothelial function by flow-mediated dilation, blood levels of isoprostanes, serum activity of soluble NOX2-dp (sNOX2-dp), and nitric oxide bioavailability, in these 2 groups of children. Serum cotinine levels were assessed to measure exposure to passive smoking. RESULTS Compared with healthy controls, children with persistent allergic rhinitis had significantly higher sNOX2-dp and isoprostanes levels, lower flow-mediated dilation, and reduced nitric oxide bioavailability. Multivariable linear regression analysis showed that flow-mediated dilation, isoprostanes, and cotinine were independently associated with sNOX2-dp levels. Of note, sNOX2-dp serum levels were significantly higher in children with allergic rhinitis exposed to smoke, as compared with unexposed children with allergic rhinitis. CONCLUSION NOX2 is activated in children with persistent allergic rhinitis and passive smoke exposure exacerbates this effect. We further demonstrate an association between higher sNOX2-dp and oxidative stress and endothelial dysfunction.
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Affiliation(s)
- Lorenzo Loffredo
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy.
| | | | - Francesca Occasi
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | - Ludovica Perri
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Roberto Carnevale
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy; Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Simona Battaglia
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Francesco Angelico
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Maria Del Ben
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | | | - Cristina Nocella
- Department of AngioCardioNeurology, IRCCS NeuroMed, Pozzilli, Italy
| | - Alessio Farcomeni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | | | - Marzia Duse
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | - Francesco Violi
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
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18
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Ismaeel A, Brumberg RS, Kirk JS, Papoutsi E, Farmer PJ, Bohannon WT, Smith RS, Eidson JL, Sawicki I, Koutakis P. Oxidative Stress and Arterial Dysfunction in Peripheral Artery Disease. Antioxidants (Basel) 2018; 7:antiox7100145. [PMID: 30347720 PMCID: PMC6210426 DOI: 10.3390/antiox7100145] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 02/07/2023] Open
Abstract
Peripheral artery disease (PAD) is an atherosclerotic disease characterized by a narrowing of the arteries in the lower extremities. Disease manifestations are the result of more than just reduced blood flow, and include endothelial dysfunction, arterial stiffness, and inflammation. Growing evidence suggests that these factors lead to functional impairment and decline in PAD patients. Oxidative stress also plays an important role in the disease, and a growing amount of data suggest a link between arterial dysfunction and oxidative stress. In this review, we present the current evidence for the involvement of endothelial dysfunction, arterial stiffness, and inflammation in the pathophysiology of PAD. We also discuss the links between these factors and oxidative stress, with a focus on nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 2 (NOX2)-derived reactive oxygen species (ROS) and decreased nitric oxide (NO) bioavailability. Finally, the potential therapeutic role of NOX2 antioxidants for improving arterial function and functional status in PAD patients is explored.
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Affiliation(s)
- Ahmed Ismaeel
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA.
| | - Robert S Brumberg
- Department of Surgery, Vascular Surgery Associates, Florida State University School of Medicine, Tallahassee Memorial Hospital, Tallahassee, FL 32308, USA.
| | - Jeffrey S Kirk
- Department of Surgery, Capital Regional Medical Center, Tallahassee, FL 32308, USA.
| | - Evlampia Papoutsi
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA.
| | - Patrick J Farmer
- Department of Chemistry and Biochemistry, Baylor University, Waco, TX 76798, USA.
| | - William T Bohannon
- Department of Surgery, Baylor Scott and White Medical Center, Temple, TX 76508, USA.
| | - Robert S Smith
- Department of Surgery, Baylor Scott and White Medical Center, Temple, TX 76508, USA.
| | - Jack L Eidson
- Department of Surgery, Baylor Scott and White Medical Center, Temple, TX 76508, USA.
| | - Ian Sawicki
- Department of Surgery, Baylor Scott and White Medical Center, Temple, TX 76508, USA.
| | - Panagiotis Koutakis
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA.
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19
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Fu J, Zou J, Chen C, Li H, Wang L, Zhou Y. Hydrogen molecules (H2) improve perfusion recovery via antioxidant effects in experimental peripheral arterial disease. Mol Med Rep 2018; 18:5009-5015. [PMID: 30320393 PMCID: PMC6236306 DOI: 10.3892/mmr.2018.9546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 09/03/2018] [Indexed: 11/24/2022] Open
Abstract
Reactive oxygen species (ROS) impair neovascularization and perfusion recovery following limb ischemia in patients with peripheral arterial disease (PAD). Hydrogen molecules (H2) comprise an antioxidant gas that has been reported to neutralize cytotoxic ROS. The present study investigated whether H2 may serve as a novel therapeutic strategy for PAD. H2-saturated water or dehydrogenized water was supplied to mice with experimental PAD. Laser Doppler perfusion imaging demonstrated that H2-saturated water improved perfusion recovery, decreased the rate of necrosis, increased the capillary density in the gastrocnemius muscle and increased the artery density in the abductor muscle in the ischemic limbs, at 14 and 21 days post-hindlimb ischemia. Ischemic muscle tissue was harvested 7 days after experimental PAD for biochemical testing and H2 was observed to reduce the levels of malondialdehyde and increase the levels of cyclic guanine monophosphate (cGMP). In cultured endothelial cells, H2-saturated culture medium resulted in reduced ROS levels, increased tube formation and increased cGMP levels. In macrophages, H2 decreased cellular ROS levels and promoted M2 polarization. H2-saturated water increases angiogenesis and arteriogenesis and subsequently improves perfusion recovery in a mouse PAD model via reduction of ROS levels.
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Affiliation(s)
- Jinrong Fu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Jinjing Zou
- Department of Respiratory Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Cheng Chen
- Department of Respiratory Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Hongying Li
- Department of Gynecology, Hubei Maternal and Child Hospital, Wuhan, Hubei 430070, P.R. China
| | - Lei Wang
- Department of Cardiology, Hubei University of Chinese Medicine, Wuhan, Hubei 430060, P.R. China
| | - Yanli Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
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20
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Thomas MC, Woodward M, Li Q, Pickering R, Tikellis C, Poulter N, Cooper ME, Marre M, Zoungas S, Chalmers J. Relationship Between Plasma 8-OH-Deoxyguanosine and Cardiovascular Disease and Survival in Type 2 Diabetes Mellitus: Results From the ADVANCE Trial. J Am Heart Assoc 2018; 7:JAHA.117.008226. [PMID: 29960985 PMCID: PMC6064915 DOI: 10.1161/jaha.117.008226] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background 8‐Oxo‐2′‐deoxyguanosine (8‐oxo‐2′‐dG) is a biomarker of oxidative DNA damage that is associated with cardiovascular disease and premature mortality in the general population. Although oxidative stress has a proven role in cardiovascular complications in diabetes mellitus, evidence for a relationship between plasma 8‐oxo‐2′‐dG and major cardiovascular outcomes in diabetes mellitus is weak. Methods and Results A case‐cohort study was performed in 3766 participants with prevalent diabetes mellitus in the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation) trial (http://ClinicalTrials.gov number NCT00145925). The hazard ratios for mortality and major acute cardiovascular events were derived using Cox regression models. During a median of 5 years of follow‐up, 695 (18.4%) participants in this enriched cohort died (including 354 deaths from cardiovascular disease). Individuals with higher levels of 8‐oxo‐2′‐dG were more likely to die. After adjusting for cardiovascular disease risk factors, the hazard ratio for a 1‐SD increase in plasma 8‐oxo‐2′‐dG was 1.10 (95% confidence interval, 1.01–1.20; P=0.03). This was driven by an independent association between plasma 8‐oxo‐2′‐dG and cardiovascular death (hazard ratio, 1.23; 95% confidence interval, 1.10–1.37 [P<0.001]). By contrast, no association was seen between 8‐oxo‐2′‐dG and noncardiovascular disease death (of which cancer was the major single cause). 8‐Oxo‐2′‐dG was also not significantly associated with either nonfatal myocardial infarction or nonfatal stroke. Conclusions In adults with type 2 diabetes mellitus, increased levels of 8‐oxo‐2′‐dG are independently associated with all‐cause mortality and cardiovascular mortality in adults with longstanding type 2 diabetes mellitus who participated in the ADVANCE trial, consistent with the role of oxidative damage in the development and progression of cardiovascular decompensation in diabetes mellitus. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00145925.
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Affiliation(s)
- Merlin C Thomas
- Department of Diabetes, Monash University, Melbourne, Australia
| | - Mark Woodward
- The George Institute for Global Health University of NSW, Sydney, Australia.,The George Institute for Global Health University of Oxford, United Kingdom.,Department of Epidemiology, Johns Hopkins University, Baltimore, MD
| | - Qiang Li
- The George Institute for Global Health University of NSW, Sydney, Australia
| | | | | | - Neil Poulter
- The International Centre for Circulatory Health, National Heart and Lung Institute Imperial College, London, United Kingdom
| | - Mark E Cooper
- Department of Diabetes, Monash University, Melbourne, Australia
| | - Michel Marre
- INSERM, UMRS 1138, Centre de Recherche des Cordeliers, Paris, France.,Department of Diabetology, Endocrinology and Nutrition, Assistance Publique Hôpitaux de Paris Bichat Hospital DHU FIRE, Paris, France.,UFR de Médecine, University Paris Diderot Sorbonne Paris Cité, Paris, France
| | - Sophia Zoungas
- The George Institute for Global Health University of NSW, Sydney, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - John Chalmers
- The George Institute for Global Health University of NSW, Sydney, Australia
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21
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Mastrangeli S, Carnevale R, Cavarretta E, Sciarretta S, Peruzzi M, Marullo AGM, De Falco E, Chimenti I, Valenti V, Bullen C, Roever L, Frati G, Biondi-Zoccai G. Predictors of oxidative stress and vascular function in an experimental study of tobacco versus electronic cigarettes: A post hoc analysis of the SUR-VAPES 1 Study. Tob Induc Dis 2018; 16:18. [PMID: 31516418 PMCID: PMC6659516 DOI: 10.18332/tid/89975] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 04/16/2018] [Accepted: 04/16/2018] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Use of a conventional cigarette (CC) or electronic cigarette (EC) leads to oxidative stress and endothelial dysfunction, but the impact of other features and their interplay with CCs and ECs have been incompletely appraised. We explored moderators of CC and EC effects on oxidative stress and endothelial dysfunction. METHODS We have conducted an experimental study on CCs and ECs in which repeated indicators of oxidative stress (serum levels of soluble NOX2-derived peptide, nitric oxide bioavailability, 8-iso-prostaglandin F2α-III, and vitamin E) and endothelial dysfunction (flow-mediated dilation) were collected in 40 subjects (20 smokers, 20 non-smokers). Several moderating features were appraised, adjusting for smoking status and cigarette type. RESULTS Absolute changes in oxidative stress and vascular features after smoking a CC or vaping an EC were significantly correlated (all p<0.05), with the notable exception of 8-iso-prostaglandin F2α-III levels (p=0.030). Inferential analysis based on generalized estimating equations highlighted that the only variable significantly associated with oxidative stress and vascular features was smoking status (all p<0.05). Specifically, we found that smokers had a less pronounced untoward oxidative and vascular response after vaping an EC in comparison to non-smokers, who had oxidative and vascular reactions to an EC that resembled more those seen after smoking a CC. Intriguingly, women taking oral contraceptives appeared to have more unfavorable changes in vitamin E (p=0.002) and FMD (p=0.008). CONCLUSIONS This study suggests that the comparative oxidative and vascular effects of an EC versus a CC may be influenced by smoking status, with a potential interaction in women taking oral contraceptives. These findings need further confirmation but could have important clinical and policy implications. ABBREVIATIONS SUR-VAPES: Sapienza University of Rome-Vascular Assessment of Proatherosclerotic Effects of Smoking
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Affiliation(s)
- Simona Mastrangeli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Roberto Carnevale
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Elena Cavarretta
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Sebastiano Sciarretta
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,Department of Angiocardioneurology, IRCCS Neuromed, Pozzilli, Italy
| | - Mariangela Peruzzi
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Antonino G M Marullo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Elena De Falco
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Isotta Chimenti
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | | | - Christopher Bullen
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Leonardo Roever
- Department of Clinical Research, Federal University of Uberlândia, Minas Gerais, Brazil
| | - Giacomo Frati
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,Department of Angiocardioneurology, IRCCS Neuromed, Pozzilli, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,Department of Angiocardioneurology, IRCCS Neuromed, Pozzilli, Italy
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22
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Giannopoulos G, Angelidis C, Vogiatzi G, Cleman MW, Deftereos S. Antioxidant treatment in peripheral artery disease: the rationale is there, but what about clinical results? Curr Opin Pharmacol 2018; 39:53-59. [DOI: 10.1016/j.coph.2018.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 01/21/2018] [Accepted: 01/31/2018] [Indexed: 10/18/2022]
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23
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Loffredo L, Baratta F, Ludovica P, Battaglia S, Carnevale R, Nocella C, Novo M, Pannitteri G, Ceci F, Angelico F, Violi F, Del Ben M. Effects of dark chocolate on endothelial function in patients with non-alcoholic steatohepatitis. Nutr Metab Cardiovasc Dis 2017; 28:143-149. [PMID: 29329924 DOI: 10.1016/j.numecd.2017.10.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/01/2017] [Accepted: 10/31/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM Oxidative stress plays a pivotal role in inducing endothelial dysfunction and progression from simple fatty liver steatosis (FLD) to non-alcoholic steatohepatitis (NASH). Polyphenols could reduce oxidative stress and restore endothelial function by inhibiting the nicotinamide-adenine-dinucleotide-phosphate (NADPH) oxidase isoform Nox2. The aim of this study was to assess endothelial function and oxidative stress in a population affected by simple FLD and NASH. Furthermore, we analysed the effect of high vs low content of cocoa polyphenols on endothelial function and oxidative stress in patients with NASH. METHODS In a cross-sectional study we analysed endothelial function, as assessed by flow-mediated dilation (FMD), and oxidative stress, as assessed by Nox2 activation, serum isoprostanes and nitric oxide bioavailability (NOx), in patients with NASH (n = 19), FLD (n = 19) and controls (n = 19). Then, we performed a randomized, cross-over study in 19 subjects with NASH comparing the effect of 14-days administration of 40 g of chocolate at high (dark chocolate, cocoa >85%) versus low content (milk chocolate, cocoa <35%) of polyphenols on FMD and oxidative stress. Compared to controls, NASH and FLD patients had higher Nox2 activity and isoprostanes levels and lower FMD and NOx, with a significant gradient between FLD and NASH. The interventional study showed that, compared to baseline, FMD and NOx increased (from 2.9 ± 2.4 to 7.2 ± 3.0% p < 0.001 and from 15.9 ± 3.6 to 20.6 ± 4.9 μM, p < 0.001, respectively) in subjects given dark but not in those given milk chocolate. A simple linear regression analysis showed that Δ (expressed by difference of values between before and after 14 days of chocolate assumption) of FMD was associated with Δ of Nox2 activity (Rs = -0.323; p = 0.04), serum isoprostanes (Rs: -0.553; p < 0.001) and NOx (Rs: 0.557; p < 0.001). CONCLUSIONS Cocoa polyphenols improve endothelial function via Nox2 down-regulation in NASH patients.
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Affiliation(s)
- L Loffredo
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Rome, Italy.
| | - F Baratta
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Rome, Italy
| | - P Ludovica
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Rome, Italy
| | - S Battaglia
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Rome, Italy
| | - R Carnevale
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Rome, Italy
| | - C Nocella
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Rome, Italy
| | - M Novo
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Rome, Italy
| | - G Pannitteri
- Department of Heart and Great Vessels "A. Reale", Sapienza University of Rome, Italy
| | - F Ceci
- Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Rome, Italy
| | - F Angelico
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - F Violi
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Rome, Italy
| | - M Del Ben
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Sapienza University of Rome, Rome, Italy
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24
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Vlasov V, Darweesh SK, Stricker BH, Franco OH, Ikram M, Kavousi M, Bos D, Klaver CC, Ikram M. Subclinical vascular disease and the risk of parkinsonism: The Rotterdam Study. Parkinsonism Relat Disord 2017; 43:27-32. [DOI: 10.1016/j.parkreldis.2017.06.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 06/03/2017] [Accepted: 06/27/2017] [Indexed: 01/18/2023]
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25
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Bellamkonda K, Williams M, Handa A, Lee R. Flow Mediated Dilatation as a Biomarker in Vascular Surgery Research. J Atheroscler Thromb 2017; 24:779-787. [PMID: 28674324 PMCID: PMC5556184 DOI: 10.5551/jat.40964] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Endothelial dysfunction is one of the hallmarks of atherogenesis, and correlates with many cardiovascular risk factors. One of the features of endothelial dysfunction is the loss of nitric oxide (NO) bioavailability, resulting in derangements in the vasodilatory response of the vessel wall. Flow mediated dilatation (FMD) of the brachial artery is an accepted method for non-invasive assessment of systemic endothelial function. FMD is examined extensively in the context of cardiovascular research, and has been utilised as a routine assessment in large cohorts such as the Framingham Heart Study, Young Finns Study, and Gutenberg Heart Study. However, FMD is less known in the context of vascular surgery research, despite the similarities between the underpinning disease mechanisms. This review will provide a summary of FMD in terms of its history of development and the conduct of the test in research settings. It will further highlight the key literature of FMD as a biomarker for vascular surgeons, particularly in the context of abdominal aortic aneurysms and lower limb peripheral arterial disease.
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Affiliation(s)
| | | | - Ashok Handa
- Nuffield Department of Surgical Sciences, University of Oxford
| | - Regent Lee
- Nuffield Department of Surgical Sciences, University of Oxford
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26
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Lee HI, Park BR, Chun SW. Reactive oxygen species increase neuronal excitability via activation of nonspecific cation channel in rat medullary dorsal horn neurons. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2017; 21:371-376. [PMID: 28706450 PMCID: PMC5507775 DOI: 10.4196/kjpp.2017.21.4.371] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 03/10/2017] [Accepted: 03/20/2017] [Indexed: 02/07/2023]
Abstract
The caudal subnucleus of the spinal trigeminal nucleus (medullary dorsal horn; MDH) receives direct inputs from small diameter primary afferent fibers that predominantly transmit nociceptive information in the orofacial region. Recent studies indicate that reactive oxygen species (ROS) is involved in persistent pain, primarily through spinal mechanisms. In this study, we aimed to investigate the role of xanthine/xanthine oxidase (X/XO) system, a known generator of superoxide anion (O2·−), on membrane excitability in the rat MDH neurons. For this, we used patch clamp recording and confocal imaging. An application of X/XO (300 µM/30 mU) induced membrane depolarization and inward currents. When slices were pretreated with ROS scavengers, such as phenyl N-tert-butylnitrone (PBN), superoxide dismutase (SOD), and catalase, X/XO-induced responses decreased. Fluorescence intensity in the DCF-DA and DHE-loaded MDH cells increased on the application of X/XO. An anion channel blocker, 4,4-diisothiocyanatostilbene-2,2-disulfonic acid (DIDS), significantly decreased X/XO-induced depolarization. X/XO elicited an inward current associated with a linear current-voltage relationship that reversed near −40 mV. X/XO-induced depolarization reduced in the presence of La3+, a nonselective cation channel (NSCC) blocker, and by lowering the external sodium concentration, indicating that membrane depolarization and inward current are induced by influx of Na+ ions. In conclusion, X/XO-induced ROS modulate the membrane excitability of MDH neurons, which was related to the activation of NSCC.
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Affiliation(s)
- Hae In Lee
- Department of Dental Hygiene, Gwangyang Health Science University, Gwangyang 57764, Korea
| | - Byung Rim Park
- Department of Physiology, College of Medicine, Wonkwang University, Iksan 54538, Korea
| | - Sang Woo Chun
- Department of Oral Physiology, College of Dentistry, Wonkwang University, Iksan 54538, Korea
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27
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Akkoca M, Usanmaz SE, Koksoy C, Bengisun U, Demirel-Yilmaz E. Plasma nitric oxide level is correlated with microvascular functions in the peripheral arterial disease. Clin Hemorheol Microcirc 2017; 65:151-162. [PMID: 27983540 DOI: 10.3233/ch-16143] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
At present there is no widely accepted biomarker for monitoring of vascular functions. The purpose of this prospective study was to investigate the association of some blood biomarkers with vascular reactivity in patients with peripheral arterial diseases (PAD). A prospective evaluation was made of 3 groups comprising a control group of healthy individuals, and patients with PAD caused by either atherosclerosis or Buerger's disease. Microvascular perfusion was examined using laser Doppler imaging of cutaneous erythrocyte flux after iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP). The correlation of microvascular reactivity with endothelium-related biomarkers was assessed. ACh-induced and SNP-induced vasodilations were significantly diminished in the PAD groups. The plasma nitric oxide (NO) levels of PAD patients were significantly higher than those of the control group, but asymmetric dimethylarginine, total antioxidant capacity and hydrogen sulphide levels were similar. Plasma NO level was negatively correlated with ACh and SNP-stimulated microvascular flow increase, whereas a positive correlation was detected with blood glucose and glycated hemoglobin (HbA1c) levels in all groups. These results indicate that a high plasma level of NO in PAD patients is associated with diminished endothelium-dependent and independent flow increase in the microvascular bed. An excessive amount of NO-induced nitrosative stress in an inflammatory condition that might be a reason for vascular dysfunction should be taken into consideration in the diagnostic and therapeutic approaches to PAD.
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Affiliation(s)
- Muzaffer Akkoca
- Department of Peripheral Vascular Surgery, Ankara University, Faculty of Medicine, Sihhiye, Ankara, Turkey
| | - Suzan Emel Usanmaz
- Department of Medical Pharmacology, Ankara University, Faculty of Medicine, Sihhiye, Ankara, Turkey
| | - Cuneyt Koksoy
- Department of Peripheral Vascular Surgery, Ankara University, Faculty of Medicine, Sihhiye, Ankara, Turkey
| | - Ugur Bengisun
- Department of Peripheral Vascular Surgery, Ankara University, Faculty of Medicine, Sihhiye, Ankara, Turkey
| | - Emine Demirel-Yilmaz
- Department of Medical Pharmacology, Ankara University, Faculty of Medicine, Sihhiye, Ankara, Turkey
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28
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Yang SL, Zhu LY, Han R, Sun LL, Li JX, Dou JT. Pathophysiology of peripheral arterial disease in diabetes mellitus. J Diabetes 2017; 9:133-140. [PMID: 27556728 DOI: 10.1111/1753-0407.12474] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 07/07/2016] [Accepted: 08/16/2016] [Indexed: 12/12/2022] Open
Abstract
Peripheral arterial disease (PAD) increases the risk of lower extremity amputation. It is also an independent predictor of cardiovascular and cerebrovascular ischemic events, affecting both the quality and expectancy of life. Many studies have demonstrated that the prevalence of PAD in patients with diabetes mellitus (DM) is higher than in non-diabetic patients. In diabetic patients, PAD occurs early with rapid progression, and is frequently asymptomatic. Multiple metabolic aberrations in DM, such as advanced glycation end-products, low-density lipoprotein cholesterol, and abnormal oxidative stress, have been shown to worsen PAD. However, the role of DM in PAD is not completely understood. The purpose of the present article is to review and discuss the pathophysiology of PAD in DM.
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Affiliation(s)
- Shao-Ling Yang
- Department of Endocrinology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Lv-Yun Zhu
- Department of Endocrinology, Bethune International Peace Hospital of PLA, Shijiazhuang, China
| | - Rui Han
- Department of Neurology, The First Affiliated Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lei-Lei Sun
- Graduate School of Logistics University of People's Armed Police Force, Tianjin, China
| | - Jun-Xia Li
- Department of Cardiology, PLA General Hospital, Beijing, China
| | - Jing-Tao Dou
- Department of Endocrinology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
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29
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Loffredo L, Cangemi R, Perri L, Catasca E, Calvieri C, Carnevale R, Nocella C, Equitani F, Ferro D, Violi F, Battaglia S, Bertazzoni G, Biliotti E, Bucci T, Calabrese CM, Casciaro M, Celestini A, De Angelis M, De Marzio P, Esvan R, Falcone M, Fazi L, Sulekova LF, Franchi C, Giordo L, Grieco S, Manzini E, Marinelli P, Mordenti M, Morelli S, Palange P, Pastori D, Pignatelli P, Capparuccia MR, Romiti GF, Rossi E, Ruscio E, Russo A, Scarpellini MG, Solimando L, Taliani G, Trapè S, Toriello F. Impaired flow-mediated dilation in hospitalized patients with community-acquired pneumonia. Eur J Intern Med 2016; 36:74-80. [PMID: 27727076 DOI: 10.1016/j.ejim.2016.09.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 06/21/2016] [Accepted: 09/09/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND Community-acquired pneumonia (CAP) is complicated by cardiovascular events as myocardial infarction and stroke but the underlying mechanism is still unclear. We hypothesized that endothelial dysfunction may be implicated and that endotoxemia may have a role. METHODS Fifty patients with CAP and 50 controls were enrolled. At admission and at discharge, flow-mediated dilation (FMD), serum levels of endotoxins and oxidative stress, as assessed by serum levels of nitrite/nitrate (NOx) and isoprostanes, were studied. RESULTS At admission, a significant difference between patients with CAP and controls was observed for FMD (2.1±0.3 vs 4.0±0.3%, p<0.001), serum endotoxins (157.8±7.6 vs 33.1±4.8pg/ml), serum isoprostanes (341±14 vs 286±10 pM, p=0.009) and NOx (24.3±1.1 vs 29.7±2.2μM). Simple linear correlation analysis showed that serum endotoxins significantly correlated with Pneumonia Severity Index score (Rs=0.386, p=0.006). Compared to baseline, at discharge CAP patients showed a significant increase of FMD and NOx (from 2.1±0.3 to 4.6±0.4%, p<0.001 and from 24.3±1.1 to 31.1±1.5μM, p<0.001, respectively) and a significant decrease of serum endotoxins and isoprostanes (from 157.8±7.6 to 55.5±2.3pg/ml, p<0.001, and from 341±14 to 312±14 pM, p<0.001, respectively). Conversely, no changes for FMD, NOx, serum endotoxins and isoprostanes were observed in controls between baseline and discharge. Changes of FMD significantly correlated with changes of serum endotoxins (Rs=-0.315; p=0.001). CONCLUSIONS The study provides the first evidence that CAP is characterized by impaired FMD with a mechanism potentially involving endotoxin production and oxidative stress.
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Affiliation(s)
- Lorenzo Loffredo
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Roberto Cangemi
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Ludovica Perri
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Elisa Catasca
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Camilla Calvieri
- Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Roberto Carnevale
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Cristina Nocella
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Francesco Equitani
- Transfusion Medicine and Immuno-Hematology Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - Domenico Ferro
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Francesco Violi
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy.
| | - Simona Battaglia
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Giuliano Bertazzoni
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Elisa Biliotti
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Tommaso Bucci
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Cinzia Myriam Calabrese
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Marco Casciaro
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Andrea Celestini
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Maurizio De Angelis
- Infectious and Tropical Diseases Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Paolo De Marzio
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Rozenn Esvan
- Infectious and Tropical Diseases Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Marco Falcone
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Lucia Fazi
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Lucia Fontanelli Sulekova
- Infectious and Tropical Diseases Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Cristiana Franchi
- Infectious and Tropical Diseases Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Laura Giordo
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Stefania Grieco
- Infectious and Tropical Diseases Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Elisa Manzini
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Paolo Marinelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Michela Mordenti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Sergio Morelli
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Paolo Palange
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Daniele Pastori
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Pasquale Pignatelli
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Marco Rivano Capparuccia
- Infectious and Tropical Diseases Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Giulio Francesco Romiti
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Elisabetta Rossi
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Eleonora Ruscio
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Alessandro Russo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Maria Gabriella Scarpellini
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Luisa Solimando
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Gloria Taliani
- Infectious and Tropical Diseases Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Stefano Trapè
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Filippo Toriello
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
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Mitochondrial genome association study with peripheral arterial disease and venous thromboembolism. Atherosclerosis 2016; 252:97-105. [DOI: 10.1016/j.atherosclerosis.2016.07.920] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 07/06/2016] [Accepted: 07/26/2016] [Indexed: 11/17/2022]
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Cangemi R, Pignatelli P, Carnevale R, Bartimoccia S, Nocella C, Falcone M, Taliani G, Violi F. Low-grade endotoxemia, gut permeability and platelet activation in community-acquired pneumonia. J Infect 2016; 73:107-14. [PMID: 27288596 DOI: 10.1016/j.jinf.2016.05.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 05/22/2016] [Accepted: 05/28/2016] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Platelet activation seems to be implicated in the cardiovascular events occurring in patients with community-acquired pneumonia (CAP) but the underlying mechanism is still unclear. Aim of the study was to assess the mechanism involved in platelet activation in CAP patients. METHODS Two-hundred-seventy-eight consecutive patients hospitalized for CAP were recruited and followed-up until discharge. Hospitalized patients matched for sex, age and comorbidities but without acute infectious diseases were used as controls. RESULTS At hospital admission patients disclosed enhanced plasma levels of sP-selectin, a maker of in-vivo platelet activation, serum sNOX2-dp, a marker of NADPH-oxidase activation, serum Lipopolysaccharide (LPS) and serum zonulin, a marker of gut permeability, compared to controls (p < 0.001). Baseline sP-selectin was independently associated to serum LPS, sNOX2-sp and Pneumonia Severity Index score (p < 0.001). Plasma sP-selectin, serum sNOX2-dp, LPS and zonulin coincidentally decreased at hospital discharge (p < 0.001). An in vitro study showed that LPS, at concentration similar to that found in CAP patients, induced sP-selectin release by agonist-activated platelets, a phenomenon that was counteract by treating cells with gp91ds-tat, a specific inhibitor of NOX2. CONCLUSIONS CAP patients display enhanced platelet activation, which is related to LPS-mediated NOX2 activation. Enhanced gut permeability seems be implicated in enhancing circulating levels of LPS.
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Affiliation(s)
- Roberto Cangemi
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
| | - Pasquale Pignatelli
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
| | - Roberto Carnevale
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
| | - Simona Bartimoccia
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
| | - Cristina Nocella
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
| | - Marco Falcone
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Gloria Taliani
- Infectious and Tropical Diseases Unit, Department of Clinical Medicine, Sapienza University of Rome, Italy
| | - Francesco Violi
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
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Carnevale R, Sciarretta S, Violi F, Nocella C, Loffredo L, Perri L, Peruzzi M, Marullo AGM, De Falco E, Chimenti I, Valenti V, Biondi-Zoccai G, Frati G. Acute Impact of Tobacco vs Electronic Cigarette Smoking on Oxidative Stress and Vascular Function. Chest 2016; 150:606-12. [PMID: 27108682 DOI: 10.1016/j.chest.2016.04.012] [Citation(s) in RCA: 257] [Impact Index Per Article: 32.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 03/25/2016] [Accepted: 04/11/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The vascular safety of electronic cigarettes (e-Cigarettes) must still be clarified. We compared the impact of e-Cigarettes vs traditional tobacco cigarettes on oxidative stress and endothelial function in healthy smokers and nonsmoker adults. METHODS A crossover, single-blind study was performed in 40 healthy subjects (20 smokers and 20 nonsmokers, matched for age and sex). First, all subjects smoked traditional tobacco cigarettes. One week later, the same subjects smoked an e-Cigarette with the same nominal nicotine content. Blood samples were drawn just before and after smoking, and markers of oxidative stress, nitric oxide bioavailability, and vitamin E levels were measured. Flow-mediated dilation (FMD) was also measured. RESULTS Smoking both e-Cigarettes and traditional cigarettes led to a significant increase in the levels of soluble NOX2-derived peptide and 8-iso-prostaglandin F2α and a significant decrease in nitric oxide bioavailability, vitamin E levels, and FMD. Generalized estimating equation analysis confirmed that all markers of oxidative stress and FMD were significantly affected by smoking and showed that the biologic effects of e-Cigarettes vstraditional cigarettes on vitamin E levels (P = .413) and FMD (P = .311) were not statistically different. However, e-Cigarettes seemed to have a lesser impact than traditional cigarettes on levels of soluble NOX2-derived peptide (P = .001), 8-iso-prostaglandin F2α (P = .046), and nitric oxide bioavailability (P = .001). CONCLUSIONS Our study showed that both cigarettes have unfavorable effects on markers of oxidative stress and FMD after single use, although e-Cigarettes seemed to have a lesser impact. Future studies are warranted to clarify the chronic vascular effects of e-Cigarette smoking.
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Affiliation(s)
- Roberto Carnevale
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy; Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.
| | - Sebastiano Sciarretta
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy; Department of AngioCardioNeurology, IRCCS NeuroMed, Pozzilli, Italy
| | - Francesco Violi
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Cristina Nocella
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy; Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Loffredo
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Ludovica Perri
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Mariangela Peruzzi
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Antonino G M Marullo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Elena De Falco
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Isotta Chimenti
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Valentina Valenti
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy; Department of AngioCardioNeurology, IRCCS NeuroMed, Pozzilli, Italy
| | - Giacomo Frati
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy; Department of AngioCardioNeurology, IRCCS NeuroMed, Pozzilli, Italy
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Jaffer U, Singh P, Aslam M, IITam FWK, Standfield NJ. Potential identification of a claudicant group vulnerable to acute kidney injury. Perfusion 2016; 31:560-7. [PMID: 26980004 DOI: 10.1177/0267659116638147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This observational study aimed to investigate the relationship between renal injury, endothelial function and oxidative stress in claudicants undergoing maximal treadmill exercise. Twenty patients with claudication were identified in whom the urinary N-acetyl-β-D-glucosaminidase (β-NAG)/creatinine ratio, plasma oxidative state and endothelial function were tested pre- and post-maximal treadmill walking exercise. Of the 20 participants in this study, the urinary NAG/creatinine (Cr) rose from a pre-exercise level of 8.9, 6.7 to 14.3 (μmol/L/mmol Cr; median, IQR) to 12.9, 9.1 to 17.7 post exercise (p = 0.0003, Mann Whitney U test). Of the 20 participants, eight participants had a rise of the NAG/Cr ratio post exercise whereas 12 did not. Participants with a rise in the NAG/Cr ratio post exercise had a greater ability to increase endothelial reactivity (%; median, IQR; 2.56, 0.1 to 3.7) cf. (0.1, -4.8 to 0.9, p = 0.03); they also walked further (metres; median, IQR; 415, 208 to 908) cf. (170, 100 to 315, p = 0.04), had a lower pre-exercise H2O2 (median, IQR; 1.9, 1.4 to 2.3 cf. 2.7, 2.1 to 3.3; p = 0.04) and a greater rise in H2O2 post exercise (18.8, -1.5 to 129.7 cf., -7.7, -13.9 to -2.0, p = 0.04). The mechanism by which the phenotypically distinct sub-group of patients with intermittent claudication who experience a NAG/Cr rise involves complex interactions between systemic oxidative stress and endothelial function. Implications on cardiovascular risk in this group requires further investigation.
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Affiliation(s)
- Usman Jaffer
- Department of Vascular Surgery, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
| | - Prashant Singh
- Department of Vascular Surgery, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
| | - Mohammed Aslam
- Department of Vascular Surgery, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
| | - Frederick Wai Keung IITam
- Department of Vascular Surgery, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
| | - Nigel J Standfield
- Department of Vascular Surgery, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
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Advanced peripheral microvascular endothelial dysfunction and polyvascular disease in patients with high cardiovascular risk. J Cardiol 2015; 67:455-62. [PMID: 26343752 DOI: 10.1016/j.jjcc.2015.07.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 06/28/2015] [Accepted: 07/01/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Polyvascular disease (PolyVD) refers to the coexistence of coronary artery disease (CAD), peripheral arterial disease (PAD), and/or cerebrovascular disease (CVD), and carries a high risk of cardiovascular mortality. Endothelial dysfunction plays a crucial role in cardiovascular pathophysiology. This study investigated the association between PolyVD and the presence of microvascular endothelial dysfunction. METHODS Consecutive stable patients (n=533) with diabetes mellitus and/or multiple cardiovascular risk factors were enrolled. Peripheral microvascular endothelial function in the finger microvasculature was assessed using the reactive hyperemia peripheral arterial tonometry index (RHI), and ankle-brachial index was measured for diagnosis of lower-extremity PAD prior to coronary angiography. Diagnosis of CVD was based on clinical symptoms, carotid ultrasound, and magnetic resonance imaging. PolyVD was defined as two or more coexisting vascular diseases from CAD, lower-extremity PAD, and CVD. RESULTS Natural logarithmic transformations of RHI (Ln-RHI) were significantly attenuated in 93 patients with PolyVD (0.44±0.20) compared with those in 440 patients without PolyVD (0.56±0.19; p<0.001) or in 299 patients with a single vascular disease (0.54±0.19; p<0.001). There was an independent correlation between Ln-RHI (per 0.1) and the presence of PolyVD in all high-risk patients [odds ratio (OR): 0.724; 95% confidence interval (CI): 0.610-0.859; p<0.001] and one or more vascular diseases (OR: 0.724; 95% CI: 0.605-0.867, p<0.001). Receiver-operating characteristics curve analysis showed that Ln-RHI correlated significantly with PolyVD (area under the curve, 0.682, 95% CI: 0.625-0.740, p<0.001). The optimum cut-off point of Ln-RHI for the existence of PolyVD was 0.479. CONCLUSIONS Microvascular endothelial dysfunction is significantly associated with the presence of PolyVD. Severe impairment of endothelial function in peripheral microvasculature may be an important pathophysiological component of PolyVD.
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de Vos LC, Boersema J, Mulder DJ, Smit AJ, Zeebregts CJ, Lefrandt JD. Skin autofluorescence as a measure of advanced glycation end products deposition predicts 5-year amputation in patients with peripheral artery disease. Arterioscler Thromb Vasc Biol 2015; 35:1532-7. [PMID: 25882066 DOI: 10.1161/atvbaha.115.305407] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 03/31/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Patients with peripheral artery disease are at risk for critical limb ischemia and amputation. Accumulation of advanced glycation end products is increased and predictive for coronary and cerebrovascular events in several high cardiovascular risk groups. We hypothesized that accumulation of tissue advanced glycation end products, measured by skin autofluorescence (SAF), predicts amputation in patients with peripheral artery disease. APPROACH AND RESULTS Between October 2007 and June 2008, 252 patients with peripheral artery disease were included at the outpatient clinic. During a 5-year follow-up, 22 (9%) had an amputation because of critical limb ischemia. Competing risks regression analysis showed a subproportional hazard ratio of 3.05 (95% confidence interval [CI], 1.87-4.96); P<0.0001 for amputation per unit incease of SAF. After correction for diabetes mellitus and Fontaine stage, subproportional hazard ratio was 2.72 (95% CI, 1.38-5.39); P=0.004. In patients with Fontaine stage I and II only (n=215), SAF was the only predictor for amputation, subproportional hazard ratio 4.05 (95% CI, 2.09-7.83); P<0.0001. Fontaine stage multiplied by SAF resulted in a significant increase of the area under the curve for prediction of amputation when compared with Fontaine stage only: area under the curve increased from 0.74 (95% CI, 0.63-0.86) to 0.83 (95% CI, 0.74-0.92); P=0.003. CONCLUSIONS Skin autofluorescence, as a measure of tissue advanced glycation end products deposition, predicts amputation in patients with peripheral artery disease during a 5-year follow-up, independent from the presence of diabetes mellitus and Fontaine stage. Even at lower Fontaine stage (I or II), SAF is a strong predictor of amputation. The multiplication of Fontaine stage by SAF results in a good prediction model of amputation.
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Affiliation(s)
- Lisanne C de Vos
- From the Department of Internal Medicine, Division of Vascular Medicine (L.C.d.V., J.B., D.J.M., A.J.S., J.D.L.) and Department of Surgery, Division of Vascular Surgery (C.J.Z.), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jeltje Boersema
- From the Department of Internal Medicine, Division of Vascular Medicine (L.C.d.V., J.B., D.J.M., A.J.S., J.D.L.) and Department of Surgery, Division of Vascular Surgery (C.J.Z.), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Douwe J Mulder
- From the Department of Internal Medicine, Division of Vascular Medicine (L.C.d.V., J.B., D.J.M., A.J.S., J.D.L.) and Department of Surgery, Division of Vascular Surgery (C.J.Z.), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Andries J Smit
- From the Department of Internal Medicine, Division of Vascular Medicine (L.C.d.V., J.B., D.J.M., A.J.S., J.D.L.) and Department of Surgery, Division of Vascular Surgery (C.J.Z.), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Clark J Zeebregts
- From the Department of Internal Medicine, Division of Vascular Medicine (L.C.d.V., J.B., D.J.M., A.J.S., J.D.L.) and Department of Surgery, Division of Vascular Surgery (C.J.Z.), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Joop D Lefrandt
- From the Department of Internal Medicine, Division of Vascular Medicine (L.C.d.V., J.B., D.J.M., A.J.S., J.D.L.) and Department of Surgery, Division of Vascular Surgery (C.J.Z.), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
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Khalaf K, Jelinek HF, Robinson C, Cornforth DJ, Tarvainen MP, Al-Aubaidy H. Complex nonlinear autonomic nervous system modulation link cardiac autonomic neuropathy and peripheral vascular disease. Front Physiol 2015; 6:101. [PMID: 25870563 PMCID: PMC4376075 DOI: 10.3389/fphys.2015.00101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 03/13/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Physiological interactions are abundant within, and between, body systems. These interactions may evolve into discrete states during pathophysiological processes resulting from common mechanisms. An association between arterial stenosis, identified by low ankle-brachial pressure index (ABPI) and cardiovascular disease (CVD) as been reported. Whether an association between vascular calcification-characterized by high ABPI and a different pathophysiology-is similarly associated with CVD, has not been established. The current study aims to investigate the association between ABPI, and cardiac rhythm, as an indicator of cardiovascular health and functionality, utilizing heart rate variability (HRV). METHODS AND RESULTS Two hundred and thirty six patients underwent ABPI assessment. Standard time and frequency domain, and non-linear HRV measures were determined from 5-min electrocardiogram. ABPI data were divided into normal (n = 101), low (n = 67) and high (n = 66) and compared to HRV measures.(DFAα1 and SampEn were significantly different between the low ABPI, high ABPI and control groups (p < 0.05). CONCLUSION A possible coupling between arterial stenosis and vascular calcification with decreased and increased HRV respectively was observed. Our results suggest a model for interpreting the relationship between vascular pathophysiology and cardiac rhythm. The cardiovascular system may be viewed as a complex system comprising a number of interacting subsystems. These cardiac and vascular subsystems/networks may be coupled and undergo transitions in response to internal or external perturbations. From a clinical perspective, the significantly increased sample entropy compared to the normal ABPI group and the decreased and increased complex correlation properties measured by DFA for the low and high ABPI groups respectively, may be useful indicators that a more holistic treatment approach in line with this more complex clinical picture is required.
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Affiliation(s)
- Kinda Khalaf
- Department of Biomedical Engineering, Khalifa University of Science, Technology and ResearchAbu Dhabi, UAE
| | - Herbert F. Jelinek
- Australian School of Advanced Medicine, Macquarie UniversitySydney, NSW, Australia
- Centre for Research in Complex Systems and School of Community Health, Charles Sturt UniversityAlbury, NSW, Australia
| | - Caroline Robinson
- School of Community Health, Charles Sturt UniversityAlbury, NSW, Australia
| | - David J. Cornforth
- School of Design, Communication and Information Technology, University of NewcastleNewcastle, NSW, Australia
| | - Mika P. Tarvainen
- Department of Applied Physics, University of Eastern FinlandKuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University HospitalKuopio, Finland
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Loffredo L, Zicari AM, Occasi F, Perri L, Carnevale R, Angelico F, Del Ben M, Martino F, Nocella C, Savastano V, Cesoni Marcelli A, Duse M, Violi F. Endothelial dysfunction and oxidative stress in children with sleep disordered breathing: role of NADPH oxidase. Atherosclerosis 2015; 240:222-7. [PMID: 25805361 DOI: 10.1016/j.atherosclerosis.2015.03.024] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 03/09/2015] [Accepted: 03/17/2015] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Oxidative stress plays a crucial role in impairing endothelial function in sleep disordered breathing (SDB) but the underlying mechanism is still undefined. The objective of this study was to evaluate the interplay between oxidative stress, assessed by serum isoprostanes (8-iso-PGF2α) and soluble NOX2-dp (sNOX2-dp), and endothelial function, assessed by flow-mediated dilation (FMD), in children with SDB and healthy controls (HC). METHODS One-hundred forty-four children including 45 with primary snoring (PS), 22 with obstructive sleep apnea (OSA) and 67 HC were recruited in this study; in 15 out of 22 OSA children FMD, serum 8-iso-PGF2α and sNOX2-dp were assessed before and after one month post adeno-tonsillectomy (AT). RESULTS Compared with HC, OSA and PS children had significantly higher sNOX2-dp and serum 8-iso-PGF2α levels and lower FMD; compared with PS, FMD was significantly lower in OSA children. No significant difference for sNOX2-dp and serum 8-iso-PGF2α was observed between OSA and PS children. FMD was inversely correlated with sNOX2-dp levels (p<0.001) and with serum 8-iso-PGF2α (p<0.001). In multiple linear regression analysis, sNOX2-dp (p<0.001) and serum 8-iso-PGF2α (p<0.001) were the only independent predictive variables associated with FMD. AT significantly decreased sNOX2-dp and serum 8-iso-PGF2α levels (from 38.2±8.8 to 22.4±11.1 pg/ml, p<0.001, and from 281.4±69.7 to 226.0±66.4 pg/ml, p<0.001, respectively); conversely, FMD significantly increased after AT in OSA children (from 3.0±1.5 to 8.0±2.8%, p<0.001). CONCLUSION This study suggests that NOX2-derived oxidative stress is involved in artery dysfunction in SDB children. Such hypothesis is reinforced by FMD improvement after AT coincidentally with oxidative stress lowering. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT02247167.
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Affiliation(s)
- Lorenzo Loffredo
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
| | | | | | - Ludovica Perri
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
| | - Roberto Carnevale
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
| | - Francesco Angelico
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Maria Del Ben
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
| | | | - Cristina Nocella
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
| | | | | | - Marzia Duse
- Department of Pediatrics, Sapienza University of Rome, Italy
| | - Francesco Violi
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
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Joris PJ, Zeegers MP, Mensink RP. Weight loss improves fasting flow-mediated vasodilation in adults: a meta-analysis of intervention studies. Atherosclerosis 2014; 239:21-30. [PMID: 25568949 DOI: 10.1016/j.atherosclerosis.2014.12.056] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 11/07/2014] [Accepted: 12/09/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Obesity is associated with vascular endothelial dysfunction. Effects of weight loss on endothelial function are however not clear. Therefore, we performed a meta-analysis to quantify effects of weight loss on flow-mediated vasodilation (FMD) of the brachial artery, a measurement of endothelial function. METHODS Studies with experimental (RCTs) and quasi-experimental designs published before June 2014 were identified by a systematic search. Changes in FMD were defined as the difference between measurements before and after the study. For RCTs, changes were corrected for those in the no-weight loss control group. Summary estimates of weighted mean differences (WMDs) in FMD and 95% confidence intervals (CIs) were calculated using random-effect meta-analyses. The impact of subject characteristics, type of weight-loss treatment, and dietary composition on changes in FMD was also investigated. RESULTS Four RCTs involving 265 subjects were included. Weight loss increased FMD vs. control by 3.29% (95% CI: 0.98-5.59%; P = 0.005; mean weight loss: 8.6 kg). A total of 1517 subjects participated in 33 studies with 49 relevant study arms. It was estimated that each 10 kg decrease in body weight increased fasting FMD by 1.11% (95% CI: 0.47-1.76%; P = 0.001). Effects were more pronounced when participants had coexisting obesity-related morbidities. Also, effects may be larger when subjects received low-fat diets or weight-reduction regimens including exercise therapy or weight-loss medication. CONCLUSION Weight loss significantly improves fasting FMD in adults, which is a risk marker for cardiovascular disease. Effects may depend on subject characteristics, type of weight-loss treatment, and dietary composition.
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Affiliation(s)
- Peter J Joris
- Department of Human Biology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands; Top Institute of Food and Nutrition (TIFN), Wageningen, The Netherlands.
| | - Maurice P Zeegers
- Department of Complex Genetics, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Ronald P Mensink
- Department of Human Biology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands; Top Institute of Food and Nutrition (TIFN), Wageningen, The Netherlands.
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Perri L, Pastori D, Pignatelli P, Violi F, Loffredo L. Flow-mediated dilation is associated with cardiovascular events in non-valvular atrial fibrillation patients. Int J Cardiol 2014; 179:139-43. [PMID: 25464433 DOI: 10.1016/j.ijcard.2014.10.039] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 09/24/2014] [Accepted: 10/18/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND Atrial fibrillation is associated with multiple atherosclerotic risk factors and predisposes to cardiovascular events (CVE). Endothelial dysfunction is associated with atherosclerosis and independently predicts CVE. The aim of the study was to evaluate the association between endothelial dysfunction, as assessed by flow-mediated dilation (FMD), and CVE in AF patients. METHODS We prospectively measured FMD in 514 non-valvular AF patients on anticoagulant treatment with vitamin K antagonists. Patients were followed-up for a mean time of 23.5 months. The main composite outcome of the study was the occurrence of stroke/TIA, myocardial infarction, urgent revascularization and cardiovascular death. RESULTS Median value of FMD was 4.6% [IQR 1.46-8.00]. A CVE occurred in 44 patients (8.56%):non-fatal myocardial infarction (MI) in 7, fatal MI in 2, stent/coronary artery by-pass graft (CABG) in 10, ischemic non-fatal stroke in 10, fatal stroke in 3, transient ischemic attack (TIA) in 1, and cardiovascular death in 11 patients. Patients who experienced a CVE showed significantly reduced FMD compared to those who did not (3.06% [IQR 0.00-6.00] vs 4.67% [IQR 1.58-8.22], p=0.027). During a mean follow-up of 23.5 months, the rate of CVE was significantly higher in subjects with FMD below median (<4.6%) than in those with FMD above median (27 vs 17, log-rank test p=0.006). COX analysis demonstrated that low FMD (below median) (HR: 2.20, CI 95%:1.13-4.28, p=0.020), age (HR: 1.08, CI 95%: 1.03-1.12, p<0.001), smoking (HR: 4.15, CI 95%: 1.63-10.6, p=0.003) and history of stroke/TIA (HR: 2.38, CI 95%: 1.13-5.04, p=0.023) independently predicted CVE. CONCLUSIONS In AF patients low FMD is associated with increased risk of CVE suggesting that impaired artery dilatation predisposes to atherosclerotic complications.
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Cangemi R, Casciaro M, Rossi E, Calvieri C, Bucci T, Calabrese CM, Taliani G, Falcone M, Palange P, Bertazzoni G, Farcomeni A, Grieco S, Pignatelli P, Violi F. Platelet activation is associated with myocardial infarction in patients with pneumonia. J Am Coll Cardiol 2014; 64:1917-25. [PMID: 25444147 DOI: 10.1016/j.jacc.2014.07.985] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 06/17/2014] [Accepted: 07/08/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Troponins may be elevated in patients with pneumonia, but associations with myocardial infarction (MI) and with platelet activation are still undefined. OBJECTIVES The aim of this study was to investigate the relationship between troponin elevation and in vivo markers of platelet activation in the early phase of hospitalization of patients affected by community-acquired pneumonia. METHODS A total of 278 consecutive patients hospitalized for community-acquired pneumonia, who were followed up until discharge, were included. At admission, platelet activation markers such as plasma soluble P-selectin, soluble CD40 ligand, and serum thromboxane B2 (TxB2) were measured. Serum high-sensitivity cardiac troponin T levels and electrocardiograms were obtained every 12 and 24 h, respectively. RESULTS Among 144 patients with elevated high-sensitivity cardiac troponin T, 31 had signs of MI and 113 did not. Baseline plasma levels of soluble P-selectin and soluble CD40 ligand and serum TxB2 were significantly higher in patients who developed signs of MI. Logistic regression analysis showed plasma soluble CD40 ligand (p < 0.001) and soluble P-selectin (p < 0.001), serum TxB2 (p = 0.030), mean platelet volume (p = 0.037), Pneumonia Severity Index score (p = 0.030), and ejection fraction (p = 0.001) to be independent predictors of MI. There were no significant differences in MI rate between the 123 patients (45%) taking aspirin (100 mg/day) and those who were not aspirin treated (12% vs. 10%; p = 0.649). Aspirin-treated patients with MIs had higher serum TxB2 compared with those without MIs (p = 0.005). CONCLUSIONS MI is an early complication of pneumonia and is associated with in vivo platelet activation and serum TxB2 overproduction; aspirin 100 mg/day seems insufficient to inhibit thromboxane biosynthesis. (MACCE in Hospitalized Patients With Community-acquired Pneumonia; NCT01773863).
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Affiliation(s)
| | - Marco Casciaro
- I Clinica Medica, Sapienza University of Rome, Rome, Italy
| | | | - Camilla Calvieri
- Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Tommaso Bucci
- I Clinica Medica, Sapienza University of Rome, Rome, Italy
| | | | - Gloria Taliani
- Infectious and Tropical Diseases Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Marco Falcone
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Paolo Palange
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Giuliano Bertazzoni
- UOC Emergency Medicine, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Alessio Farcomeni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Stefania Grieco
- Infectious and Tropical Diseases Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
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Epicatechin and catechin modulate endothelial activation induced by platelets of patients with peripheral artery disease. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2014; 2014:691015. [PMID: 25180068 PMCID: PMC4142301 DOI: 10.1155/2014/691015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 07/20/2014] [Indexed: 02/05/2023]
Abstract
Platelet activation contributes to the alteration of endothelial function, a critical initial step in atherogenesis through the production and release of prooxidant mediators. There is uncertainty about the precise role of polyphenols in interaction between platelets and endothelial cells (ECs). We aimed to investigate whether polyphenols are able to reduce endothelial activation induced by activated platelets. First, we compared platelet activation and flow-mediated dilation (FMD) in 10 healthy subjects (HS) and 10 patients with peripheral artery disease (PAD). Then, we evaluated the effect of epicatechin plus catechin on platelet-HUVEC interaction by measuring soluble cell adhesion molecules (CAMs), NOx production, and eNOS phosphorylation (p-eNOS) in HUVEC. Compared to HS, PAD patients had enhanced platelet activation. Conversely, PAD patients had lower FMD than HS. Supernatant of activated platelets from PAD patients induced an increase of sCAMs release and a decrease of p-eNOS and nitric oxide (NO) bioavailability compared to unstimulated HUVEC. Coincubation of HUVEC, with supernatant of PAD platelets patients, pretreated with a scalar dose of the polyphenols, resulted in a decrease of sCAMs release and in an increase of p-eNOS and NO bioavailability. This study demonstrates that epicatechin plus catechin reduces endothelial activation induced by activated platelets.
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Januszek R, Mika P, Konik A, Petriczek T, Nowobilski R, Niżankowski R. The effect of treadmill training on endothelial function and walking abilities in patients with peripheral arterial disease. J Cardiol 2014; 64:145-51. [DOI: 10.1016/j.jjcc.2013.12.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 12/02/2013] [Accepted: 12/06/2013] [Indexed: 11/16/2022]
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Loffredo L, Perri L, Catasca E, Pignatelli P, Brancorsini M, Nocella C, De Falco E, Bartimoccia S, Frati G, Carnevale R, Violi F. Dark chocolate acutely improves walking autonomy in patients with peripheral artery disease. J Am Heart Assoc 2014; 3:jah3578. [PMID: 24990275 PMCID: PMC4310398 DOI: 10.1161/jaha.114.001072] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background NOX‐2, the catalytic subunit of NADPH oxidase, has a key role in the formation of reactive oxidant species and is implicated in impairing flow‐mediated dilation (FMD). Dark chocolate exerts artery dilatation via down‐regulating NOX2‐mediated oxidative stress. The aim of this study was to investigate whether dark chocolate improves walking autonomy in peripheral artery disease (PAD) patients via an oxidative stress‐mediated mechanism. Methods and Results FMD, serum levels of isoprostanes, nitrite/nitrate (NOx) and sNOX2‐dp, a marker of blood NOX2 activity, maximal walking distance (MWD) and maximal walking time (MWT) were studied in 20 PAD patients (14 males and 6 females, mean age: 69±9 years) randomly allocated to 40 g of dark chocolate (>85% cocoa) or 40 g of milk chocolate (≤35% cocoa) in a single blind, cross‐over design. The above variables were assessed at baseline and 2 hours after chocolate ingestion. Dark chocolate intake significantly increased MWD (+11%; P<0.001), MWT (+15%; P<0.001), serum NOx (+57%; P<0.001) and decreased serum isoprostanes (−23%; P=0.01) and sNOX2‐dp (−37%; P<0.001); no changes of the above variables were observed after milk chocolate intake. Serum epicatechin and its methylated metabolite significantly increased only after dark chocolate ingestion. Multiple linear regression analysis showed that Δ of MWD was independently associated with Δ of MWT (P<0.001) and Δ of NOx (P=0.018). In vitro study demonstrated that HUVEC incubated with a mixture of polyphenols significantly increased nitric oxide (P<0.001) and decreased E‐selectin (P<0.001) and VCAM1 (P<0.001). Conclusion In PAD patients dark but not milk chocolate acutely improves walking autonomy with a mechanism possibly related to an oxidative stress‐mediated mechanism involving NOX2 regulation. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01947712.
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Affiliation(s)
- Lorenzo Loffredo
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy (L.L., L.P., E.C., P.P., M.B., C.N., S.B., R.C., F.V.)
| | - Ludovica Perri
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy (L.L., L.P., E.C., P.P., M.B., C.N., S.B., R.C., F.V.)
| | - Elisa Catasca
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy (L.L., L.P., E.C., P.P., M.B., C.N., S.B., R.C., F.V.)
| | - Pasquale Pignatelli
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy (L.L., L.P., E.C., P.P., M.B., C.N., S.B., R.C., F.V.)
| | - Monica Brancorsini
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy (L.L., L.P., E.C., P.P., M.B., C.N., S.B., R.C., F.V.)
| | - Cristina Nocella
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy (L.L., L.P., E.C., P.P., M.B., C.N., S.B., R.C., F.V.)
| | - Elena De Falco
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy (E.D.F., G.F.)
| | - Simona Bartimoccia
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy (L.L., L.P., E.C., P.P., M.B., C.N., S.B., R.C., F.V.)
| | - Giacomo Frati
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy (E.D.F., G.F.) Department of AngioCardioNeurology, IRCCS NeuroMed, Pozzilli, Italy (G.F.)
| | - Roberto Carnevale
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy (L.L., L.P., E.C., P.P., M.B., C.N., S.B., R.C., F.V.)
| | - Francesco Violi
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy (L.L., L.P., E.C., P.P., M.B., C.N., S.B., R.C., F.V.)
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Carnevale R, Pignatelli P, Nocella C, Loffredo L, Pastori D, Vicario T, Petruccioli A, Bartimoccia S, Violi F. Extra virgin olive oil blunt post-prandial oxidative stress via NOX2 down-regulation. Atherosclerosis 2014; 235:649-58. [PMID: 24980290 DOI: 10.1016/j.atherosclerosis.2014.05.954] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 04/30/2014] [Accepted: 05/27/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Olive oil protects against cardiovascular disease but the underlying mechanism is still unclear. We speculated that olive oil could inhibit oxidative stress, which is believed to be implicated in the atherosclerotic process. METHODS AND RESULTS Post-prandial oxidative stress and endothelial dysfunction were investigated in twenty-five healthy subjects who were randomly allocated in a cross-over design to a Mediterranean diet added with or without extra virgin olive oil (EVOO, 10 g) (first study, n = 25) or Mediterranean diet with EVOO (10 g) or corn oil (10 g) (second study, n = 25). Oxidative stress biomarkers including platelet reactive oxidant species (ROS) and 8-iso-PGF2α-III, activity of NOX2, the catalytic sub-unit of NADPH oxidase, as assessed in platelets and serum, serum vitamin E and endothelial dysfunction, were measured before and 2 h after lunch. In the first study a significant increase of platelet ROS, 8-iso-PGF2α-III, NOX2 activity, sE-selectin, sVCAM1 and a decrease of serum vitamin E were detected in controls but not when EVOO was included in the Mediterranean diet; oxidative stress and endothelial dysfunction increase were also observed in the second study in subjects given corn oil. A significant correlation was found between NOX2 activity and platelet oxidative stress. In vitro study demonstrated that EVOO but not corn oil significantly decreased platelet and PMNs oxidative stress and NOX2 activity. CONCLUSION The study provides the first evidence that post-prandial oxidative stress may be triggered by NOX2 up-regulation. EVOO but not corn oil, is able to counteract such phenomenon suggesting that addition of EVOO to a Mediterranean diet protects against post-prandial oxidative stress.
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Affiliation(s)
- Roberto Carnevale
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Pasquale Pignatelli
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Cristina Nocella
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Loffredo
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Daniele Pastori
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Tommasa Vicario
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Andreina Petruccioli
- AFC Patrimonio Servizi e furniture UO ristorazioni, Policlinico Umberto I, Rome, Italy
| | - Simona Bartimoccia
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Francesco Violi
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy.
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Propionyl-L-Carnitine is Efficacious in Ulcerative Colitis Through its Action on the Immune Function and Microvasculature. Clin Transl Gastroenterol 2014; 5:e55. [PMID: 24646507 PMCID: PMC3972692 DOI: 10.1038/ctg.2014.4] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 12/05/2013] [Accepted: 12/30/2013] [Indexed: 02/06/2023] Open
Abstract
Objectives: Microvascular endothelial dysfunction characterizes ulcerative colitis (UC), the most widespread form of inflammatory bowel disease. Intestinal mucosal microvessels in UC display aberrant expression of cell adhesion molecules (CAMs) and increased inflammatory cell recruitment. Propionyl-L-carnitine (PLC), an ester of L-carnitine required for the mitochondrial transport of fatty acids, ameliorates propionyl-CoA bioavailability and reduces oxidative stress in ischemic tissues. The present study aimed to document the efficacy of anti-oxidative stress properties of PLC in counteracting intestinal microvascular endothelial dysfunction and inflammation. Methods: To evaluate the efficacy in vivo, we analyzed the effects in intestinal biopsies of patients with mild-to-moderate UC receiving oral PLC co-treatment and in rat TNBS-induced colitis; in addition, we investigated antioxidant PLC action in TNF-α-stimulated human intestinal microvascular endothelial cells (HIMECs) in vitro. Results: Four-week PLC co-treatment reduced intestinal mucosal polymorph infiltration and CD4+ lymphocytes, ICAM-1+ and iNOS+ microvessels compared with placebo-treated patients with UC. Oral and intrarectal administration of PLC but not L-carnitine or propionate reduced intestinal damage and microvascular dysfunction in rat TNBS-induced acute and reactivated colitis. In cultured TNF-α-stimulated HIMECs, PLC restored β-oxidation and counteracted NADPH oxidase 4-generated oxidative stress-induced CAM expression and leukocyte adhesion. Inhibition of β-oxidation by L-aminocarnitine increased reactive oxygen species production and PLC beneficial effects on endothelial dysfunction and leukocyte adhesion. Finally, PLC reduced iNOS activity and nitric oxide accumulation in rat TNBS-induced colitis and in HIMEC cultures. Conclusions: Our results show that the beneficial antioxidant effect of PLC targeting intestinal microvasculature restores endothelial β-oxidation and function, and reduces mucosal inflammation in UC patients.
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Baltgalvis KA, White K, Li W, Claypool MD, Lang W, Alcantara R, Singh BK, Friera AM, McLaughlin J, Hansen D, McCaughey K, Nguyen H, Smith IJ, Godinez G, Shaw SJ, Goff D, Singh R, Markovtsov V, Sun TQ, Jenkins Y, Uy G, Li Y, Pan A, Gururaja T, Lau D, Park G, Hitoshi Y, Payan DG, Kinsella TM. Exercise performance and peripheral vascular insufficiency improve with AMPK activation in high-fat diet-fed mice. Am J Physiol Heart Circ Physiol 2014; 306:H1128-45. [PMID: 24561866 DOI: 10.1152/ajpheart.00839.2013] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Intermittent claudication is a form of exercise intolerance characterized by muscle pain during walking in patients with peripheral artery disease (PAD). Endothelial cell and muscle dysfunction are thought to be important contributors to the etiology of this disease, but a lack of preclinical models that incorporate these elements and measure exercise performance as a primary end point has slowed progress in finding new treatment options for these patients. We sought to develop an animal model of peripheral vascular insufficiency in which microvascular dysfunction and exercise intolerance were defining features. We further set out to determine if pharmacological activation of 5'-AMP-activated protein kinase (AMPK) might counteract any of these functional deficits. Mice aged on a high-fat diet demonstrate many functional and molecular characteristics of PAD, including the sequential development of peripheral vascular insufficiency, increased muscle fatigability, and progressive exercise intolerance. These changes occur gradually and are associated with alterations in nitric oxide bioavailability. Treatment of animals with an AMPK activator, R118, increased voluntary wheel running activity, decreased muscle fatigability, and prevented the progressive decrease in treadmill exercise capacity. These functional performance benefits were accompanied by improved mitochondrial function, the normalization of perfusion in exercising muscle, increased nitric oxide bioavailability, and decreased circulating levels of the endogenous endothelial nitric oxide synthase inhibitor asymmetric dimethylarginine. These data suggest that aged, obese mice represent a novel model for studying exercise intolerance associated with peripheral vascular insufficiency, and pharmacological activation of AMPK may be a suitable treatment for intermittent claudication associated with PAD.
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Togliatto G, Trombetta A, Dentelli P, Cotogni P, Rosso A, Tschöp MH, Granata R, Ghigo E, Brizzi MF. Unacylated ghrelin promotes skeletal muscle regeneration following hindlimb ischemia via SOD-2-mediated miR-221/222 expression. J Am Heart Assoc 2013; 2:e000376. [PMID: 24308935 PMCID: PMC3886736 DOI: 10.1161/jaha.113.000376] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background Surgical treatment of peripheral artery disease, even if successful, does not prevent reoccurrence. Under these conditions, increased oxidative stress is a crucial determinant of tissue damage. Given its reported antioxidant effects, we investigated the potential of unacylated‐ghrelin (UnAG) to reduce ischemia‐induced tissue damage in a mouse model of peripheral artery disease. Methods and Results We show that UnAG but not acylated ghrelin (AG) induces skeletal muscle regeneration in response to ischemia via canonical p38/mitogen‐actived protein kinase signaling UnAG protected against reactive oxygen species–induced cell injuries by inducing the expression of superoxide dismutase‐2 (SOD‐2) in satellite cells. This led to a reduced number of infiltrating CD68+ cells and was followed by induction of the myogenic process and a reduction in functional impairment. Moreover, we found that miR‐221/222, previously linked to muscle regeneration processes, was up‐regulated and negatively correlated with p57Kip2 expression in UnAG‐treated mice. UnAG, unlike AG, promoted cell‐cycle entry in satellite cells of mice lacking the genes for ghrelin and its receptor (GHSR1a). UnAG‐induced p38/mitogen‐actived protein kinase phosphorylation, leading to activation of the myogenic process, was prevented in SOD‐2–depleted SCs. By siRNA technology, we also demonstrated that SOD‐2 is the antioxidant enzyme involved in the control of miR‐221/222–driven posttranscriptional p57Kip2 regulation. Loss‐of‐function experiments targeting miR‐221/222 and local pre–miR‐221/222 injection in vivo confirmed a role for miR‐221/222 in driving skeletal muscle regeneration after ischemia. Conclusions These results indicate that UnAG‐induced skeletal muscle regeneration after ischemia depends on SOD‐2–induced miR‐221/222 expression and highlight its clinical potential for the treatment of reactive oxygen species–mediated skeletal muscle damage.
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Drew RC, Muller MD, Blaha CA, Mast JL, Heffernan MJ, Estep LE, Cui J, Reed AB, Sinoway LI. Renal vasoconstriction is augmented during exercise in patients with peripheral arterial disease. Physiol Rep 2013; 1:e00154. [PMID: 24400156 PMCID: PMC3871469 DOI: 10.1002/phy2.154] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 10/15/2013] [Accepted: 10/16/2013] [Indexed: 11/09/2022] Open
Abstract
Peripheral arterial disease (PAD) patients have augmented blood pressure increases during exercise, heightening their cardiovascular risk. However, it is unknown whether patients have exaggerated renal vasoconstriction during exercise and if oxidative stress contributes to this response. Eleven PAD patients and 10 controls (CON) performed 4-min mild, rhythmic, plantar flexion exercise of increasing intensity (0.5-2 kg) with each leg (most and least affected in PAD). Eight patients also exercised with their most affected leg during ascorbic acid (AA) infusion. Renal blood flow velocity (RBFV; Doppler ultrasound), mean arterial blood pressure (MAP; Finometer), and heart rate (HR; electrocardiogram [ECG]) were measured. Renal vascular resistance (RVR), an index of renal vasoconstriction, was calculated as MAP/RBFV. Baseline RVR and MAP were similar while HR was higher in PAD than CON (2.08 ± 0.23 vs. 1.87 ± 0.20 au, 94 ± 3 vs. 93 ± 3 mmHg, and 72 ± 3 vs. 59 ± 3 bpm [P < 0.05] for PAD and CON, respectively). PAD had greater RVR increases during exercise than CON, specifically during the first minute (PAD most: 26 ± 5% and PAD least: 17 ± 5% vs. CON: 3 ± 3%; P < 0.05). AA did not alter baseline RVR, MAP, or HR. AA attenuated the augmented RVR increase in PAD during the first minute of exercise (PAD most: 33 ± 4% vs. PAD most with AA: 21 ± 4%; P < 0.05). In conclusion, these findings suggest that PAD patients have augmented renal vasoconstriction during exercise, with oxidative stress contributing to this response.
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Affiliation(s)
- Rachel C Drew
- Penn State Hershey Heart and Vascular Institute, Penn State University College of Medicine Hershey, Pennsylvania
| | - Matthew D Muller
- Penn State Hershey Heart and Vascular Institute, Penn State University College of Medicine Hershey, Pennsylvania
| | - Cheryl A Blaha
- Penn State Hershey Heart and Vascular Institute, Penn State University College of Medicine Hershey, Pennsylvania
| | - Jessica L Mast
- Penn State Hershey Heart and Vascular Institute, Penn State University College of Medicine Hershey, Pennsylvania
| | - Matthew J Heffernan
- Penn State Hershey Heart and Vascular Institute, Penn State University College of Medicine Hershey, Pennsylvania
| | - Lauren E Estep
- Penn State Hershey Heart and Vascular Institute, Penn State University College of Medicine Hershey, Pennsylvania
| | - Jian Cui
- Penn State Hershey Heart and Vascular Institute, Penn State University College of Medicine Hershey, Pennsylvania
| | - Amy B Reed
- Penn State Hershey Heart and Vascular Institute, Penn State University College of Medicine Hershey, Pennsylvania
| | - Lawrence I Sinoway
- Penn State Hershey Heart and Vascular Institute, Penn State University College of Medicine Hershey, Pennsylvania
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Babicová A, Havlínová Z, Hroch M, Rezáčová M, Pejchal J, Vávrová J, Chládek J. In vivo study of radioprotective effect of NO-synthase inhibitors and acetyl-L-carnitine. Physiol Res 2013; 62:701-10. [PMID: 23869893 DOI: 10.33549/physiolres.932541] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study investigated the protective effect of two nitric oxide synthase inhibitors N(omega)-nitro-L-arginine methyl ester (L-NAME, 100 mg/kg i.p.) and aminoguanidine (AG, 400 mg/kg i.p.), and an antioxidant acetyl-L-carnitine (ALC, 250 mg/kg i.p., once daily for five days) against radiation-induced damage in Wistar rats. Blood samples were collected 6 h after whole-body irradiation with 8 Gy. Plasma concentrations of nitrite+nitrate (NO(x)) and malondialdehyde (MDA) were measured by high-performance liquid chromatography. A single injection of L-NAME one hour before exposure effectively prevented the radiation-induced elevation of plasma NO(x) and it reduced 2.6-fold the risk for death during the subsequent 30-day period. Pretreatment with ALC prevented the radiation-induced increase in plasma MDA and it had similar effect on mortality as L-NAME did. Presumably due to its short half-life, the partially iNOS-selective inhibitor and antioxidant AG given in a single dose before exposure did not attenuate MDA and NO(x) and it failed to significantly improve the 30-day survival. In conclusion, pretreatment with both the nonspecific NOS inhibitor L-NAME and the antioxidant ALC markedly reduce mortality to radiation sickness in rats. The radioprotective effect may be directly related to effective attenuation of the radiation-induced elevation of NO production by L-NAME and of oxidative stress by ALC.
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Affiliation(s)
- A Babicová
- Department of Medical Biochemistry, Charles University, Faculty of Medicine, Hradec Kralove, Czech Republic.
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