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Gaballah M, Penttinen K, Kreutzer J, Mäki AJ, Kallio P, Aalto-Setälä K. Cardiac Ischemia On-a-Chip: Antiarrhythmic Effect of Levosimendan on Ischemic Human-Induced Pluripotent Stem Cell-Derived Cardiomyocytes. Cells 2022; 11:cells11061045. [PMID: 35326497 PMCID: PMC8947267 DOI: 10.3390/cells11061045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 02/05/2023] Open
Abstract
Ischemic heart disease (IHD) is one of the leading causes of mortality worldwide. Preserving functionality and preventing arrhythmias of the heart are key principles in the management of patients with IHD. Levosimendan, a unique calcium (Ca2+) enhancer with inotropic activity, has been introduced into clinical usage for heart failure treatment. Human-induced pluripotent cell-derived cardiomyocytes (hiPSC-CMs) offer an opportunity to better understand the pathophysiological mechanisms of the disease as well as to serve as a platform for drug screening. Here, we developed an in vitro IHD model using hiPSC-CMs in hypoxic conditions and defined the effects of the subsequent hypoxic stress on CMs functionality. Furthermore, the effect of levosimendan on hiPSC-CMs functionality was evaluated during and after hypoxic stress. The morphology, contractile, Ca2+-handling, and gene expression properties of hiPSC-CMs were investigated in response to hypoxia. Hypoxia resulted in significant cardiac arrhythmia and decreased Ca2+ transient amplitude. In addition, disorganization of sarcomere structure was observed after hypoxia induction. Interestingly, levosimendan presented significant antiarrhythmic properties, as the arrhythmia was abolished or markedly reduced with levosimendan treatment either during or after the hypoxic stress. Moreover, levosimendan presented significant protection from the sarcomere alterations induced by hypoxia. In conclusion, this chip model appears to be a suitable preclinical representation of IHD. With this hypoxia platform, detailed knowledge of the disease pathophysiology can be obtained. The antiarrhythmic effect of levosimendan was clearly observed, suggesting a possible new clinical use for the drug.
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Affiliation(s)
- Mahmoud Gaballah
- Heart Group, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (K.P.); (K.A.-S.)
- Department of Forensic Medicine and Toxicology, Faculty of Veterinary Medicine, University of Sadat City, Menoufia 32897, Egypt
- Correspondence: ; Tel.: +358-402574148
| | - Kirsi Penttinen
- Heart Group, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (K.P.); (K.A.-S.)
| | - Joose Kreutzer
- Micro- and Nanosystems Research Group, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (J.K.); (A.-J.M.); (P.K.)
| | - Antti-Juhana Mäki
- Micro- and Nanosystems Research Group, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (J.K.); (A.-J.M.); (P.K.)
| | - Pasi Kallio
- Micro- and Nanosystems Research Group, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (J.K.); (A.-J.M.); (P.K.)
| | - Katriina Aalto-Setälä
- Heart Group, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (K.P.); (K.A.-S.)
- Heart Hospital, Tampere University Hospital, 33520 Tampere, Finland
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Droujinine IA, Meyer AS, Wang D, Udeshi ND, Hu Y, Rocco D, McMahon JA, Yang R, Guo J, Mu L, Carey DK, Svinkina T, Zeng R, Branon T, Tabatabai A, Bosch JA, Asara JM, Ting AY, Carr SA, McMahon AP, Perrimon N. Proteomics of protein trafficking by in vivo tissue-specific labeling. Nat Commun 2021; 12:2382. [PMID: 33888706 PMCID: PMC8062696 DOI: 10.1038/s41467-021-22599-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/19/2021] [Indexed: 02/06/2023] Open
Abstract
Conventional approaches to identify secreted factors that regulate homeostasis are limited in their abilities to identify the tissues/cells of origin and destination. We established a platform to identify secreted protein trafficking between organs using an engineered biotin ligase (BirA*G3) that biotinylates, promiscuously, proteins in a subcellular compartment of one tissue. Subsequently, biotinylated proteins are affinity-enriched and identified from distal organs using quantitative mass spectrometry. Applying this approach in Drosophila, we identify 51 muscle-secreted proteins from heads and 269 fat body-secreted proteins from legs/muscles, including CG2145 (human ortholog ENDOU) that binds directly to muscles and promotes activity. In addition, in mice, we identify 291 serum proteins secreted from conditional BirA*G3 embryo stem cell-derived teratomas, including low-abundance proteins with hormonal properties. Our findings indicate that the communication network of secreted proteins is vast. This approach has broad potential across different model systems to identify cell-specific secretomes and mediators of interorgan communication in health or disease.
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Affiliation(s)
- Ilia A Droujinine
- Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA, USA.
- Department of Molecular Medicine, Scripps Research, La Jolla, CA, USA.
| | - Amanda S Meyer
- Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Los Angeles, CA, USA
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of Southern California, Los Angeles, CA, USA
| | - Dan Wang
- Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
- Department of Entomology, China Agricultural University, Beijing, China
| | | | - Yanhui Hu
- Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - David Rocco
- Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Jill A McMahon
- Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Los Angeles, CA, USA
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of Southern California, Los Angeles, CA, USA
| | - Rui Yang
- Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Los Angeles, CA, USA
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of Southern California, Los Angeles, CA, USA
| | - JinJin Guo
- Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Los Angeles, CA, USA
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of Southern California, Los Angeles, CA, USA
| | - Luye Mu
- Department of Electrical Engineering, Yale University, New Haven, CT, USA
| | | | | | - Rebecca Zeng
- Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Tess Branon
- Chan Zuckerberg Biohub, San Francisco, CA, USA
| | - Areya Tabatabai
- Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Justin A Bosch
- Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - John M Asara
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Signal Transduction, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Alice Y Ting
- Chan Zuckerberg Biohub, San Francisco, CA, USA
- Departments of Genetics, Biology, and Chemistry, Stanford University, Stanford, CA, USA
| | - Steven A Carr
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Andrew P McMahon
- Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Los Angeles, CA, USA
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of Southern California, Los Angeles, CA, USA
| | - Norbert Perrimon
- Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA, USA.
- Howard Hughes Medical Institute, Boston, MA, USA.
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Lawley JS, Gatterer H, Dias KA, Howden EJ, Sarma S, Cornwell WK, Hearon CM, Samels M, Everding B, Bruick RK, Hendrix M, Piper T, Thevis M, Levine BD. Safety, hemodynamic effects, and detection of acute xenon inhalation: rationale for banning xenon from sport. J Appl Physiol (1985) 2019; 127:1511-1518. [DOI: 10.1152/japplphysiol.00290.2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
This study aimed to quantify the sedative effects, detection rates, and cardiovascular responses to xenon. On 3 occasions, participants breathed xenon (FiXe 30% for 20 min; FiXe 50% for 5 min; FiXe 70% for 2 min) in a nonblinded design. Sedation was monitored by a board-certified anesthesiologist. During 70% xenon, participants were also verbally instructed to operate a manual value with time-to-task failure being recorded. Beat-by-beat hemodynamics were measured continuously by ECG, photoplethysmography, and transcranial Doppler. Over 48 h postadministration, xenon was measured in blood and urine by gas chromatography-mass spectrometry. Xenon caused variable levels of sedation and restlessness. Task failure of the self-operating value occurred at 60–90 s in most individuals. Over the first minute, 50% and 70% xenon caused a substantial reduction in total peripheral resistance ( P < 0.05). All dosages caused an increase in cardiac output ( P < 0.05). By the end of xenon inhalation, slight hypertension was observed after all three doses ( P < 0.05), with an increase in middle cerebral artery velocity ( P < 0.05). Xenon was consistently detected, albeit in trace amounts, up to 3 h after all three doses of xenon inhalation in blood and urine with variable results thereafter. Xenon inhalation caused sedation incompatible with self-operation of a breathing apparatus, thus causing a potential life-threatening condition in the absence of an anesthesiologist. Yet, xenon can only be reliably detected in blood and urine up to 3 h postacute dosing. NEW & NOTEWORTHY Breathing xenon in dosages conceivable for doping purposes (FiXe 30% for 20 min; FiXe 50% for 5 min; FiXe 70% for 2 min) causes an initial rapid fall in total peripheral resistance with tachycardia and thereafter a mild hypertension with elevated middle cerebral artery velocity. These dose duration intervals cause sedation that is incompatible with operating a breathing apparatus and can only be detected in blood and urine samples with a high probability for up to ~3 h.
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Affiliation(s)
- Justin S. Lawley
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Hannes Gatterer
- Institute of Mountain Emergency Medicine, EURAC Research, Bolzano, Italy
| | - Katrin A. Dias
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Erin J. Howden
- The Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Satyam Sarma
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Christopher M. Hearon
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Mitchel Samels
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
| | - Braden Everding
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
| | | | - Max Hendrix
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Thomas Piper
- German Sport University Cologne, Institute of Biochemistry/Center for Preventive Doping Research, Cologne, Germany
| | - Mario Thevis
- German Sport University Cologne, Institute of Biochemistry/Center for Preventive Doping Research, Cologne, Germany
| | - Benjamin D. Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
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Dias KA, Lawley JS, Gatterer H, Howden EJ, Sarma S, Cornwell WK, Hearon CM, Samels M, Everding B, Liang ASW, Hendrix M, Piper T, Thevis M, Bruick RK, Levine BD. Effect of acute and chronic xenon inhalation on erythropoietin, hematological parameters, and athletic performance. J Appl Physiol (1985) 2019; 127:1503-1510. [DOI: 10.1152/japplphysiol.00289.2019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study aimed to assess the efficacy of acute subanesthetic dosages of xenon inhalation to cause erythropoiesis and determine the effect of chronic xenon dosing on hematological parameters and athletic performance. To assess the acute effects, seven subjects breathed three subanesthetic concentrations of xenon: 30% fraction of inspired xenon (FiXe) for 20 min, 50% FiXe for 5 min, and 70% FiXe for 2 min. Erythropoietin (EPO) was measured at baseline, during, and after xenon inhalation. To determine the chronic effects, eight subjects breathed 70% FiXe for 2 min on 7 consecutive days, and EPO, total blood, and plasma volume were measured. Phase II involved assessment of 12 subjects for EPO, total blood volume, maximal oxygen uptake, and 3-km time before and after random assignment to 4 wk of xenon or sham gas inhalation. FiXe 50% and 70% stimulated an increase in EPO at 6 h [+2.3 mIU/mL; 95% confidence interval (CI) 0.1–4.5; P = 0.038] and at 192 h postinhalation (+2.9 mIU/mL; 95% CI 0.6–5.1; P = 0.017), respectively. Seven consecutive days of dosing significantly elevated plasma volume (+491 mL; 95% CI 194–789; P = 0.002). Phase II showed no significant effect on EPO, hemoglobin mass, plasma volume, maximal oxygen uptake, or 3-km time. Acute exposure to subanesthetic doses of xenon caused a consistent increase in EPO, and 7 consecutive days of xenon inhalation significantly expanded plasma volume. However, this physiological response appeared to be transient, and 4 wk of xenon inhalation did not stimulate increases in plasma volume or erythropoiesis, leaving cardiorespiratory fitness and athletic performance unchanged. NEW & NOTEWORTHY This is the first study to examine each element of the cascade by which xenon inhalation is purported to take effect, starting with measurement of the hypoxia-inducible factor effector, erythropoietin, to hemoglobin mass and blood volume and athletic performance. We found that acute exposure to xenon increased serum erythropoietin concentration, although major markers of erythropoiesis remained unchanged. While daily dosing significantly expanded plasma volume, no physiological or performance benefits were apparent following 4 wk of dosing.
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Affiliation(s)
- Katrin A. Dias
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Justin S. Lawley
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Sports Science, University of Innsbruck, Innsbruck, Austria
| | - Hannes Gatterer
- Department of Sports Science, University of Innsbruck, Innsbruck, Austria
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Erin J. Howden
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Satyam Sarma
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Christopher M. Hearon
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Mitchel Samels
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
| | - Braden Everding
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
| | | | - Max Hendrix
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Thomas Piper
- German Sport University Cologne, Institute of Biochemistry/Centre for Preventive Doping Research, Cologne, Germany
| | - Mario Thevis
- German Sport University Cologne, Institute of Biochemistry/Centre for Preventive Doping Research, Cologne, Germany
| | | | - Benjamin D. Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
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Hong XY, Hong X, Gu WW, Lin J, Yin WT. Cardioprotection and improvement in endothelial-dependent vasodilation during late-phase of whole body hypoxic preconditioning in spontaneously hypertensive rats via VEGF and endothelin-1. Eur J Pharmacol 2018; 842:79-88. [PMID: 30401629 DOI: 10.1016/j.ejphar.2018.10.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/17/2018] [Accepted: 10/24/2018] [Indexed: 12/13/2022]
Abstract
The present study was designed to investigate the effect of late phase of whole body hypoxic preconditioning on endothelial-dependent vasorelaxation and cardioprotection from ischemia-reperfusion injury in spontaneously hypertensive rats (SHR). Hypoxic preconditioning was performed by subjecting rats to four episodes of alternate exposure to low O2 (8%) and normal air O2 of 10 min each. After 24 h, the mesenteric arteries and hearts were isolated to determine the vascular function and cardioprotection from ischemia-reperfusion (I/R) injury on the Langendorff apparatus. There was a significant impairment in acetylcholine-induced relaxation in norepinephrine precontracted arteries (endothelium-dependent function) and increase in I/R-induced myocardial injury in SHR in comparison to Wistar Kyoto rats (WKY). However, hypoxic preconditioning significantly restored endothelium-dependent relaxation in SHR and attenuated I/R injury in both SHR and WKY. Hypoxic preconditioning also led to an increase in the levels of endothelin-1 (not endothelin-2 or -3), vascular endothelial growth factor-A (VEGF-A) and HIF-1α levels. Pretreatment with bevacizumab (anti-VEGF-A) and bosentan (endothelin receptor blocker) significantly attenuated hypoxic preconditioning-induced restoration of endothelium-dependent relaxation and cardioprotection from I/R injury. These interventions also attenuated the levels of VEGF-A and HIF-1α without modulating the endothelin-1 levels. It may be concluded that an increase in the endothelin-1 levels with a subsequent increase in HIF-1α and VEGF expression may possibly contribute in improving endothelium-dependent vasorelaxation and protecting hearts from I/R injury in SHR during late phase of whole body hypoxic preconditioning.
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Affiliation(s)
- Xing-Yu Hong
- Department of Vascular Surgery, China-Japan Union Hospital of JiLin University, ChangChun 130031, China.
| | - Xin Hong
- Department of Vascular Surgery, China-Japan Union Hospital of JiLin University, ChangChun 130031, China.
| | - Wei-Wei Gu
- Department of Hepatopancreatobility Surgery, China-Japan Union Hospital of JiLin University, ChangChun 130031, China.
| | - Jie Lin
- Department of Vascular Surgery, China-Japan Union Hospital of JiLin University, ChangChun 130031, China.
| | - Wei-Tian Yin
- Department of Hand Surgery, China-Japan Union Hospital of JiLin University, ChangChun 130031, China.
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Wendt S, Goetzenich A, Goettsch C, Stoppe C, Bleilevens C, Kraemer S, Benstoem C. Evaluation of the cardioprotective potential of extracellular vesicles - a systematic review and meta-analysis. Sci Rep 2018; 8:15702. [PMID: 30356109 PMCID: PMC6200786 DOI: 10.1038/s41598-018-33862-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/07/2018] [Indexed: 12/20/2022] Open
Abstract
Cardiovascular diseases are the main cause of death worldwide, demanding new treatments and interventions. Recently, extracellular vesicles (EVs) came in focus as important carriers of protective molecules such as miRNAs and proteins which might contribute to e.g. improved cardiac function after myocardial infarction. EVs can be secreted from almost every cell type in the human body and can be transferred via the bloodstream in almost every compartment. To provide an all-encompassing overview of studies investigating these beneficial properties of EVs we performed a systematic review/meta-analysis of studies investigating the cardioprotective characteristics of EVs. Forty-three studies were investigated and catalogued according to the EV source. We provide an in-depth analysis of the purification method, size of the EVs, the conducted experiments to investigate the beneficial properties of EVs as well as the major effector molecule encapsulated in EVs mediating protection. This study provides evidence that EVs from different cell types and body fluids provide cardioprotection in different in vivo and in vitro studies. A meta-analysis was performed to estimate the underlying effect size. In conclusion, we demonstrated that EVs from different sources might serve as a promising tool for treating cardiovascular diseases in the future.
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Affiliation(s)
- Sebastian Wendt
- Department of Thoracic and Cardiovascular Surgery, Medical Faculty RWTH Aachen, Aachen, Germany. .,Cardiovascular Critical Care & Anaesthesia research and evaluation (3CARE), Medical Faculty RWTH Aachen, Aachen, Germany.
| | - Andreas Goetzenich
- Department of Thoracic and Cardiovascular Surgery, Medical Faculty RWTH Aachen, Aachen, Germany.,Cardiovascular Critical Care & Anaesthesia research and evaluation (3CARE), Medical Faculty RWTH Aachen, Aachen, Germany
| | - Claudia Goettsch
- Department of Internal Medicine I-Cardiology, Medical Faculty RWTH Aachen, Aachen, Germany
| | - Christian Stoppe
- Cardiovascular Critical Care & Anaesthesia research and evaluation (3CARE), Medical Faculty RWTH Aachen, Aachen, Germany.,Department of Intensive Care Medicine, Medical Faculty RWTH Aachen, Aachen, Germany
| | | | - Sandra Kraemer
- Department of Thoracic and Cardiovascular Surgery, Medical Faculty RWTH Aachen, Aachen, Germany.,Cardiovascular Critical Care & Anaesthesia research and evaluation (3CARE), Medical Faculty RWTH Aachen, Aachen, Germany
| | - Carina Benstoem
- Cardiovascular Critical Care & Anaesthesia research and evaluation (3CARE), Medical Faculty RWTH Aachen, Aachen, Germany.,Department of Intensive Care Medicine, Medical Faculty RWTH Aachen, Aachen, Germany
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Grilo GA, Shaver PR, de Castro Brás LE. Mechanisms of cardioprotection via modulation of the immune response. Curr Opin Pharmacol 2017; 33:6-11. [PMID: 28388508 PMCID: PMC11034833 DOI: 10.1016/j.coph.2017.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/03/2017] [Accepted: 03/08/2017] [Indexed: 10/19/2022]
Abstract
Both morbidity and mortality as a result of cardiovascular disease remain significant worldwide and account for approximately 31% of annual deaths in the US. Current research is focused on novel therapeutic strategies to protect the heart during and after ischemic events and from subsequent adverse myocardial remodeling. After cardiac insult, the immune system is activated and plays an essential role in the beginning, development, and resolution of the healing cascade. Uncontrolled inflammatory responses can cause chronic disease and exacerbate progression to heart failure and therefore, constitute a major area of focus of cardiac therapies. In the present overview, we share novel insights and promising therapeutic cardioprotective strategies that target the immune response.
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Affiliation(s)
- Gabriel A Grilo
- The Brody School of Medicine, Department of Physiology, East Carolina University, 600 Moye Blvd, Greenville NC 27834, USA
| | - Patti R Shaver
- The Brody School of Medicine, Department of Physiology, East Carolina University, 600 Moye Blvd, Greenville NC 27834, USA
| | - Lisandra E de Castro Brás
- The Brody School of Medicine, Department of Physiology, East Carolina University, 600 Moye Blvd, Greenville NC 27834, USA.
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Abstract
BACKGROUND Despite substantial success in the anesthetic and surgical management of cardiac surgery, patients frequently show postoperative complications and organ dysfunctions. This is highly relevant for mid- to long-term outcomes. OBJECTIVES To evaluate cardioprotective strategies that may offer effective protection in vulnerable cardiac surgery patients. METHODS To demonstrate recent cardioprotective approaches for cardiac surgery patients, aiming to modulate the body's own protective mechanisms in cardiac surgery patients. RESULTS Both cardioplegia and hypothermia belong to the well-established protective strategies during myocardial ischemia. Volatile anesthetics have been repeatedly shown to improve the left ventricular function and reduce the extent of myocardial injury compared to a control group with intravenous anesthesia. Furthermore, patients receiving volatile anesthetics showed a significantly shortened stay in the ICU and in hospital after cardiac surgery. In contrast, numerous other protective strategies failed translation into the clinical practice. Despite the published reduction of troponin release after remote ischemic preconditioning, two recent large-scale randomized multicenter trials were unable to demonstrate a clinical benefit. CONCLUSIONS Beside the use of cardioplegia and hypothermia, the use of volatile anesthetics is well-established during cardiac surgery because of its conditioning and protective properties. Regardless of the promising results derived from experimental studies and small clinical trials, the majority of other approaches failed to translate their findings into the clinic. Therefore, systematic experimental studies are needed to identify potential confounding factors that may affect the protective effects.
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Stoppe C, Ney J, Rossaint R, Coburn M, Goetzenich A. Authors' Reply to Anoop Balachandran et al.: Comment on "Sub-Anesthetic Xenon Increases Erythropoietin Levels in Humans: A Randomized Controlled Trial". Sports Med 2016; 47:381-382. [PMID: 27933562 DOI: 10.1007/s40279-016-0660-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Christian Stoppe
- Department of Intensive Care Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
| | - Julia Ney
- Department of Anaesthesiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Rolf Rossaint
- Department of Anaesthesiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Mark Coburn
- Department of Anaesthesiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Andreas Goetzenich
- Department of Thoracic, Cardiac and Vascular Surgery, University Hospital RWTH Aachen, Aachen, Germany
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10
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Mayer B, Soppert J, Kraemer S, Schemmel S, Beckers C, Bleilevens C, Rossaint R, Coburn M, Goetzenich A, Stoppe C. Argon Induces Protective Effects in Cardiomyocytes during the Second Window of Preconditioning. Int J Mol Sci 2016; 17:E1159. [PMID: 27447611 DOI: 10.3390/ijms17071159] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 06/29/2016] [Accepted: 07/08/2016] [Indexed: 12/23/2022] Open
Abstract
Increasing evidence indicates that argon has organoprotective properties. So far, the underlying mechanisms remain poorly understood. Therefore, we investigated the effect of argon preconditioning in cardiomyocytes within the first and second window of preconditioning. Primary isolated cardiomyocytes from neonatal rats were subjected to 50% argon for 1 h, and subsequently exposed to a sublethal dosage of hypoxia (<1% O2) for 5 h either within the first (0–3 h) or second window (24–48 h) of preconditioning. Subsequently, the cell viability and proliferation was measured. The argon-induced effects were assessed by evaluation of mRNA and protein expression after preconditioning. Argon preconditioning did not show any cardioprotective effects in the early window of preconditioning, whereas it leads to a significant increase of cell viability 24 h after preconditioning compared to untreated cells (p = 0.015) independent of proliferation. Argon-preconditioning significantly increased the mRNA expression of heat shock protein (HSP) B1 (HSP27) (p = 0.048), superoxide dismutase 2 (SOD2) (p = 0.001), vascular endothelial growth factor (VEGF) (p < 0.001) and inducible nitric oxide synthase (iNOS) (p = 0.001). No difference was found with respect to activation of pro-survival kinases in the early and late window of preconditioning. The findings provide the first evidence of argon-induced effects on the survival of cardiomyocytes during the second window of preconditioning, which may be mediated through the induction of HSP27, SOD2, VEGF and iNOS.
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Schaefer MS, Piper T, Geyer H, Schneemann J, Neukirchen M, Thevis M, Kienbaum P. Xenon elimination kinetics following brief exposure. Drug Test Anal 2016; 9:666-670. [PMID: 27341380 DOI: 10.1002/dta.2001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 04/22/2016] [Accepted: 05/05/2016] [Indexed: 11/09/2022]
Abstract
Xenon is a modern inhalative anaesthetic with a very low solubility in tissues providing rapid elimination and weaning from anaesthesia. Besides its anaesthetic properties, Xenon promotes the endogenous erythropoietin biosynthesis and thus has been enlisted as prohibited substance by the World Anti-Doping Agency (WADA). For effective doping controls, knowledge about the elimination kinetics of Xenon and the duration of traceability are of particular importance. Seventy-seven full blood samples were obtained from 7 normal weight patients undergoing routine Xenon-based general anaesthesia with a targeted inspiratory concentration of 60% Xenon in oxygen. Samples were taken before and during Xenon inhalation as well as one, two, 4, 8, 16, 24, 32, 40, and 48 h after exposure. Xenon concentrations were assessed in full blood by gas chromatography and triple quadrupole tandem mass spectrometry with a detection limit of 0.25 µmol/L. The elimination of Xenon was characterized by linear regression of log-transformed Xenon blood concentrations, as well as non-linear regression. Xenon exposure yielded maximum concentrations in arterial blood of 1.3 [1.1; 1.6] mmol/L. Xenon was traceable for 24 to 48 h. The elimination profile was characterized by a biphasic pattern with a rapid alpha phase, followed by a slower beta phase showing a first order kinetics (c[Xe] = 69.1e-0.26x , R2 = 0.83, t1/2 = 2.7 h). Time in hours after exposure could be estimated by 50*ln(1.39/c[Xe]0.077 ). Xenon's elimination kinetics is biphasic with a delayed beta phase following a first order kinetics. Xenon can reliably be detected for at least 24 h after brief exposure. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
| | - Thomas Piper
- Center for Preventive Doping Research - Institute of Biochemistry, German Sports University Cologne, Germany
| | - Hans Geyer
- Center for Preventive Doping Research - Institute of Biochemistry, German Sports University Cologne, Germany
| | - Julia Schneemann
- Department of Anaesthesiology, University Hospital Düsseldorf, Germany
| | - Martin Neukirchen
- Department of Anaesthesiology, University Hospital Düsseldorf, Germany
| | - Mario Thevis
- Center for Preventive Doping Research - Institute of Biochemistry, German Sports University Cologne, Germany
| | - Peter Kienbaum
- Department of Anaesthesiology, University Hospital Düsseldorf, Germany
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Fan W, Liu Q, Zhu X, Wu Z, Li D, Huang F, He H. Regulatory effects of anesthetics on nitric oxide. Life Sci 2016; 151:76-85. [DOI: 10.1016/j.lfs.2016.02.094] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 02/20/2016] [Accepted: 02/26/2016] [Indexed: 12/26/2022]
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Revuelta M, Arteaga O, Alvarez A, Martinez-Ibargüen A, Hilario E. Characterization of Gene Expression in the Rat Brainstem After Neonatal Hypoxic–Ischemic Injury and Antioxidant Treatment. Mol Neurobiol 2016; 54:1129-1143. [DOI: 10.1007/s12035-016-9724-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 01/13/2016] [Indexed: 11/29/2022]
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Maze M. Preclinical neuroprotective actions of xenon and possible implications for human therapeutics: a narrative review. Can J Anaesth 2015; 63:212-26. [PMID: 26507536 DOI: 10.1007/s12630-015-0507-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 08/30/2015] [Accepted: 10/02/2015] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The purpose of this report is to facilitate an understanding of the possible application of xenon for neuroprotection in critical care settings. This narrative review appraises the literature assessing the efficacy and safety of xenon in preclinical models of acute ongoing neurologic injury. SOURCE Databases of the published literature (MEDLINE® and EMBASE™) were appraised for peer-reviewed manuscripts addressing the use of xenon in both preclinical models and disease states of acute ongoing neurologic injury. For randomized clinical trials not yet reported, the investigators' declarations in the National Institutes of Health clinical trials website were considered. PRINCIPAL FINDINGS While not a primary focus of this review, to date, xenon cannot be distinguished as superior for surgical anesthesia over existing alternatives in adults. Nevertheless, studies in a variety of preclinical disease models from multiple laboratories have consistently shown xenon's neuroprotective properties. These properties are enhanced in settings where xenon is combined with hypothermia. Small randomized clinical trials are underway to explore xenon's efficacy and safety in clinical settings of acute neurologic injury where hypothermia is the current standard of care. CONCLUSION According to the evidence to date, the neuroprotective efficacy of xenon in preclinical models and its safety in clinical anesthesia set the stage for the launch of randomized clinical trials to determine whether these encouraging neuroprotective findings can be translated into clinical utility.
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Affiliation(s)
- Mervyn Maze
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, 1001 Potrero Avenue, Box 1363, San Francisco, CA, 94110, USA.
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Schaefer M, Apfel C, Sachs H, Stuttmann R, Bein B, Tonner P, Hein M, Neukirchen M, Reyle-hahn M, Kienbaum P. Predictors for postoperative nausea and vomiting after xenon-based anaesthesia. Br J Anaesth 2015; 115:61-7. [DOI: 10.1093/bja/aev115] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2015] [Indexed: 11/14/2022] Open
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Stoppe C, Coburn M, Fahlenkamp A, Ney J, Kraemer S, Rossaint R, Goetzenich A. Elevated serum concentrations of erythropoietin after xenon anaesthesia in cardiac surgery: secondary analysis of a randomized controlled trial. Br J Anaesth 2015; 114:701-3. [PMID: 25788631 DOI: 10.1093/bja/aev060] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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Unterkofler J, Goetzenich A. Myokardiale Protektion und Konditionierung. Z Herz- Thorax- Gefäßchir 2014; 28:464-469. [DOI: 10.1007/s00398-014-1095-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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