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Amput P, Palee S, Arunsak B, Pratchayasakul W, Kerdphoo S, Jaiwongkam T, Chattipakorn SC, Chattipakorn N. PCSK9 inhibitor effectively attenuates cardiometabolic impairment in obese-insulin resistant rats. Eur J Pharmacol 2020; 883:173347. [PMID: 32650007 DOI: 10.1016/j.ejphar.2020.173347] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 06/21/2020] [Accepted: 07/02/2020] [Indexed: 12/22/2022]
Abstract
Long-term high-fat diet consumption causes obese-insulin resistance and cardiac mitochondrial dysfunction, leading to impaired left ventricular (LV) function. Atorvastatin effectively improved lipid profiles in obese patients. However, inadequate reduction in low density lipoprotein cholesterol (LDL-C) level was found. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor effectively reduced LDL-C levels. We hypothesized that this PCSK9 inhibitor has a greater efficacy in attenuating cardiometabolic impairments than atorvastatin in obese-insulin resistant rats. Female rats were fed with either a high fat or normal diet for 12 weeks. High fat diet fed rats (HFD) were then divided into 3 groups and were given vehicle, atorvastatin (40 mg/kg/day; s.c.), or PCSK9 inhibitor (4 mg/kg/day; s.c.) for additional 3 weeks. The metabolic parameters, cardiac and mitochondrial function and [Ca2+]i transients were determined. HFD rats developed obese-insulin resistance as indicated by increased plasma insulin and HOMA index. Although high-fat diet fed rats treated with vehicle (HFV) rats had markedly impaired LV function as indicated by reduced %LVFS, impaired cardiac mitochondrial function, and [Ca2+]i transient regulation, these impairments were attenuated in high-fat diet fed rats treated with atorvastatin (HFA) and high-fat diet fed rats treated with PCSK9 inhibitor (HFP) rats. However, these improvements were greater in HFP rats than HFA rats. Our findings indicated that the PCSK9 inhibitor exerted greater cardioprotection than atorvastatin through improved mitochondrial function in obese-insulin resistant rats.
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Affiliation(s)
- Patchareeya Amput
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand; Department of Physical Therapy, Faculty of Allied Health Science, University of Phayao, Phayao, 56000, Thailand
| | - Siripong Palee
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Busarin Arunsak
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Wasana Pratchayasakul
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Sasiwan Kerdphoo
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Thidarat Jaiwongkam
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Siriporn C Chattipakorn
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nipon Chattipakorn
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand.
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van Beers EJ, Yang Y, Raghavachari N, Tian X, Allen DT, Nichols JS, Mendelsohn L, Nekhai S, Gordeuk VR, Taylor JG, Kato GJ. Iron, inflammation, and early death in adults with sickle cell disease. Circ Res 2015; 116:298-306. [PMID: 25378535 PMCID: PMC4297524 DOI: 10.1161/circresaha.116.304577] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 11/06/2014] [Indexed: 01/19/2023]
Abstract
RATIONALE Patients with sickle cell disease (SCD) have markers of chronic inflammation, but the mechanism of inflammation and its relevance to patient survival are unknown. OBJECTIVE To assess the relationship between iron, inflammation, and early death in SCD. METHODS AND RESULTS Using peripheral blood mononuclear cell transcriptome profile hierarchical clustering, we classified 24 patients and 10 controls in clusters with significantly different expression of genes known to be regulated by iron. Subsequent gene set enrichment analysis showed that many genes associated with the high iron cluster were involved in the toll-like receptor system (TLR4, TLR7, and TLR8) and inflammasome complex pathway (NLRP3, NLRC4, and CASP1). Quantitative PCR confirmed this classification and showed that ferritin light chain, TLR4, and interleukin-6 expression were >100-fold higher in patients than in controls (P<0.001). Further linking intracellular iron and inflammation, 14 SCD patients with a ferroportin Q248H variant that causes intracellular iron accumulation had significantly higher levels of interleukin-6 and C-reactive protein compared with 14 matched SCD patients with the wild-type allele (P<0.05). Finally, in a cohort of 412 patients followed for a median period of 47 months (interquartile range, 24-82), C-reactive protein was strongly and independently associated with early death (hazard ratio, 3.0; 95% confidence interval, 1.7-5.2; P<0.001). CONCLUSIONS Gene expression markers of high intracellular iron in patients with SCD are associated with markers of inflammation and mortality. The results support a model in which intracellular iron promotes inflammatory pathways, such as the TLR system and the inflammasome, identifying important new pathways for additional investigation.
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Affiliation(s)
- Eduard J van Beers
- From the Hematology Branch (E.J.v.B., D.T.A., J.S.N., L.M., J.G.T., G.J.K.), Genomics Core Facility (Y.Y., N.R.), and Office of Biostatistics Research (X.T.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; Center for Sickle Cell Disease, Department of Medicine, Howard University, Washington, DC (S.N.); Comprehensive Sickle Cell Center, Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago (V.R.G.); and Division of Hematology-Oncology, Department of Medicine and the Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, PA (G.J.K.). Current address: Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands (E.J.v.B.)
| | - Yanqin Yang
- From the Hematology Branch (E.J.v.B., D.T.A., J.S.N., L.M., J.G.T., G.J.K.), Genomics Core Facility (Y.Y., N.R.), and Office of Biostatistics Research (X.T.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; Center for Sickle Cell Disease, Department of Medicine, Howard University, Washington, DC (S.N.); Comprehensive Sickle Cell Center, Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago (V.R.G.); and Division of Hematology-Oncology, Department of Medicine and the Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, PA (G.J.K.). Current address: Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands (E.J.v.B.)
| | - Nalini Raghavachari
- From the Hematology Branch (E.J.v.B., D.T.A., J.S.N., L.M., J.G.T., G.J.K.), Genomics Core Facility (Y.Y., N.R.), and Office of Biostatistics Research (X.T.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; Center for Sickle Cell Disease, Department of Medicine, Howard University, Washington, DC (S.N.); Comprehensive Sickle Cell Center, Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago (V.R.G.); and Division of Hematology-Oncology, Department of Medicine and the Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, PA (G.J.K.). Current address: Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands (E.J.v.B.)
| | - Xin Tian
- From the Hematology Branch (E.J.v.B., D.T.A., J.S.N., L.M., J.G.T., G.J.K.), Genomics Core Facility (Y.Y., N.R.), and Office of Biostatistics Research (X.T.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; Center for Sickle Cell Disease, Department of Medicine, Howard University, Washington, DC (S.N.); Comprehensive Sickle Cell Center, Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago (V.R.G.); and Division of Hematology-Oncology, Department of Medicine and the Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, PA (G.J.K.). Current address: Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands (E.J.v.B.)
| | - Darlene T Allen
- From the Hematology Branch (E.J.v.B., D.T.A., J.S.N., L.M., J.G.T., G.J.K.), Genomics Core Facility (Y.Y., N.R.), and Office of Biostatistics Research (X.T.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; Center for Sickle Cell Disease, Department of Medicine, Howard University, Washington, DC (S.N.); Comprehensive Sickle Cell Center, Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago (V.R.G.); and Division of Hematology-Oncology, Department of Medicine and the Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, PA (G.J.K.). Current address: Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands (E.J.v.B.)
| | - James S Nichols
- From the Hematology Branch (E.J.v.B., D.T.A., J.S.N., L.M., J.G.T., G.J.K.), Genomics Core Facility (Y.Y., N.R.), and Office of Biostatistics Research (X.T.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; Center for Sickle Cell Disease, Department of Medicine, Howard University, Washington, DC (S.N.); Comprehensive Sickle Cell Center, Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago (V.R.G.); and Division of Hematology-Oncology, Department of Medicine and the Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, PA (G.J.K.). Current address: Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands (E.J.v.B.)
| | - Laurel Mendelsohn
- From the Hematology Branch (E.J.v.B., D.T.A., J.S.N., L.M., J.G.T., G.J.K.), Genomics Core Facility (Y.Y., N.R.), and Office of Biostatistics Research (X.T.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; Center for Sickle Cell Disease, Department of Medicine, Howard University, Washington, DC (S.N.); Comprehensive Sickle Cell Center, Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago (V.R.G.); and Division of Hematology-Oncology, Department of Medicine and the Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, PA (G.J.K.). Current address: Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands (E.J.v.B.)
| | - Sergei Nekhai
- From the Hematology Branch (E.J.v.B., D.T.A., J.S.N., L.M., J.G.T., G.J.K.), Genomics Core Facility (Y.Y., N.R.), and Office of Biostatistics Research (X.T.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; Center for Sickle Cell Disease, Department of Medicine, Howard University, Washington, DC (S.N.); Comprehensive Sickle Cell Center, Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago (V.R.G.); and Division of Hematology-Oncology, Department of Medicine and the Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, PA (G.J.K.). Current address: Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands (E.J.v.B.)
| | - Victor R Gordeuk
- From the Hematology Branch (E.J.v.B., D.T.A., J.S.N., L.M., J.G.T., G.J.K.), Genomics Core Facility (Y.Y., N.R.), and Office of Biostatistics Research (X.T.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; Center for Sickle Cell Disease, Department of Medicine, Howard University, Washington, DC (S.N.); Comprehensive Sickle Cell Center, Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago (V.R.G.); and Division of Hematology-Oncology, Department of Medicine and the Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, PA (G.J.K.). Current address: Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands (E.J.v.B.)
| | - James G Taylor
- From the Hematology Branch (E.J.v.B., D.T.A., J.S.N., L.M., J.G.T., G.J.K.), Genomics Core Facility (Y.Y., N.R.), and Office of Biostatistics Research (X.T.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; Center for Sickle Cell Disease, Department of Medicine, Howard University, Washington, DC (S.N.); Comprehensive Sickle Cell Center, Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago (V.R.G.); and Division of Hematology-Oncology, Department of Medicine and the Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, PA (G.J.K.). Current address: Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands (E.J.v.B.)
| | - Gregory J Kato
- From the Hematology Branch (E.J.v.B., D.T.A., J.S.N., L.M., J.G.T., G.J.K.), Genomics Core Facility (Y.Y., N.R.), and Office of Biostatistics Research (X.T.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; Center for Sickle Cell Disease, Department of Medicine, Howard University, Washington, DC (S.N.); Comprehensive Sickle Cell Center, Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago (V.R.G.); and Division of Hematology-Oncology, Department of Medicine and the Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, PA (G.J.K.). Current address: Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands (E.J.v.B.).
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