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SenthilKumar G, Katunaric B, Zirgibel Z, Lindemer B, Jaramillo-Torres MJ, Bordas-Murphy H, Schulz ME, Pearson PJ, Freed JK. Necessary Role of Ceramides in the Human Microvascular Endothelium During Health and Disease. Circ Res 2024; 134:81-96. [PMID: 38037825 PMCID: PMC10766100 DOI: 10.1161/circresaha.123.323445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Elevated plasma ceramides and microvascular dysfunction both independently predict adverse cardiac events. Despite the known detrimental effects of ceramide on the microvasculature, evidence suggests that activation of the shear-sensitive, ceramide-forming enzyme NSmase (neutral sphingomyelinase) elicits formation of vasoprotective nitric oxide (NO). Here, we explore a novel hypothesis that acute ceramide formation through NSmase is necessary for maintaining NO signaling within the human microvascular endothelium. We further define the mechanism through which ceramide exerts beneficial effects and discern key mechanistic differences between arterioles from otherwise healthy adults (non-coronary artery disease [CAD]) and patients diagnosed with CAD. METHODS Human arterioles were dissected from discarded surgical adipose tissue (n=166), and vascular reactivity to flow and C2-ceramide was assessed. Shear-induced NO and mitochondrial hydrogen peroxide (H2O2) production were measured in arterioles using fluorescence microscopy. H2O2 fluorescence was assessed in isolated human umbilical vein endothelial cells. RESULTS Inhibition of NSmase in arterioles from otherwise healthy adults induced a switch from NO to NOX-2 (NADPH-oxidase 2)-dependent H2O2-mediated flow-induced dilation. Endothelial dysfunction was prevented by treatment with sphingosine-1-phosphate (S1P) and partially prevented by C2-ceramide and an agonist of S1P-receptor 1 (S1PR1); the inhibition of the S1P/S1PR1 signaling axis induced endothelial dysfunction via NOX-2. Ceramide increased NO production in arterioles from non-CAD adults, an effect that was diminished with inhibition of S1P/S1PR1/S1P-receptor 3 signaling. In arterioles from patients with CAD, inhibition of NSmase impaired the overall ability to induce mitochondrial H2O2 production and subsequently dilate to flow, an effect not restored with exogenous S1P. Acute ceramide administration to arterioles from patients with CAD promoted H2O2 as opposed to NO production, an effect dependent on S1P-receptor 3 signaling. CONCLUSION These data suggest that despite differential downstream signaling between health and disease, NSmase-mediated ceramide formation is necessary for proper functioning of the human microvascular endothelium. Therapeutic strategies that aim to significantly lower ceramide formation may prove detrimental to the microvasculature.
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Affiliation(s)
- Gopika SenthilKumar
- Department of Physiology (G.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
- Cardiovascular Center (G.S., Z.Z., B.L., M.J.J.-T., H.B.-M., M.E.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
- Department of Anesthesiology (G.S., B.K., Z.Z., B.L., M.J.J.-T., H.B.-M., M.E.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
| | - Boran Katunaric
- Department of Anesthesiology (G.S., B.K., Z.Z., B.L., M.J.J.-T., H.B.-M., M.E.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
| | - Zachary Zirgibel
- Cardiovascular Center (G.S., Z.Z., B.L., M.J.J.-T., H.B.-M., M.E.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
- Department of Anesthesiology (G.S., B.K., Z.Z., B.L., M.J.J.-T., H.B.-M., M.E.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
| | - Brian Lindemer
- Cardiovascular Center (G.S., Z.Z., B.L., M.J.J.-T., H.B.-M., M.E.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
- Department of Anesthesiology (G.S., B.K., Z.Z., B.L., M.J.J.-T., H.B.-M., M.E.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
| | - Maria J. Jaramillo-Torres
- Cardiovascular Center (G.S., Z.Z., B.L., M.J.J.-T., H.B.-M., M.E.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
- Department of Anesthesiology (G.S., B.K., Z.Z., B.L., M.J.J.-T., H.B.-M., M.E.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
| | - Henry Bordas-Murphy
- Cardiovascular Center (G.S., Z.Z., B.L., M.J.J.-T., H.B.-M., M.E.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
- Department of Anesthesiology (G.S., B.K., Z.Z., B.L., M.J.J.-T., H.B.-M., M.E.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
| | - Mary E. Schulz
- Cardiovascular Center (G.S., Z.Z., B.L., M.J.J.-T., H.B.-M., M.E.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
- Department of Anesthesiology (G.S., B.K., Z.Z., B.L., M.J.J.-T., H.B.-M., M.E.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
| | - Paul J. Pearson
- Department of Surgery, Division of Cardiothoracic Surgery (P.J.P.), Medical College of Wisconsin, Milwaukee, WI
| | - Julie K. Freed
- Department of Physiology (G.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
- Cardiovascular Center (G.S., Z.Z., B.L., M.J.J.-T., H.B.-M., M.E.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
- Department of Anesthesiology (G.S., B.K., Z.Z., B.L., M.J.J.-T., H.B.-M., M.E.S., J.K.F.), Medical College of Wisconsin, Milwaukee, WI
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SenthilKumar G, Heisner JS, Schlaak R, Mishra J, Katunaric B, Pedersen LN, Lavine K, Javaheri A, Camara AK, Bergom C. Targeted Cardiac Ionizing Radiation in Dahl Salt-Sensitive Rats Can Improve Recovery From Ischemic Injury. JACC Basic Transl Sci 2023; 8:1025-1027. [PMID: 37719423 PMCID: PMC10504396 DOI: 10.1016/j.jacbts.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | - Amadou K.S. Camara
- Department of Anesthesiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, Wisconsin 53226, USA
| | - Carmen Bergom
- Department of Radiation Oncology, Washington University School of Medicine, 4921 Parkview Place, St. Louis, Missouri 63110, USA
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SenthilKumar G, Katunaric B, Zirgibel Z, Lindemer B, Jaramillo-Torres MJ, Bordas-Murphy H, Schulz ME, Pearson PJ, Freed JK. Necessary Role of Acute Ceramide Formation in The Human Microvascular Endothelium During Health and Disease. bioRxiv 2023:2023.06.02.543341. [PMID: 37333082 PMCID: PMC10274701 DOI: 10.1101/2023.06.02.543341] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Background Elevated plasma ceramides independently predict adverse cardiac events and we have previously shown that exposure to exogenous ceramide induces microvascular endothelial dysfunction in arterioles from otherwise healthy adults (0-1 risk factors for heart disease). However, evidence also suggests that activation of the shear-sensitive, ceramide forming enzyme neutral sphingomyelinase (NSmase) enhances vasoprotective nitric oxide (NO) production. Here we explore a novel hypothesis that acute ceramide formation through NSmase is necessary for maintaining NO signaling within the human microvascular endothelium. We further define the mechanism through which ceramide exerts beneficial effects and discern key mechanistic differences between arterioles from otherwise healthy adults and patients with coronary artery disease (CAD). Methods Human arterioles were dissected from otherwise discarded surgical adipose tissue (n=123), and vascular reactivity to flow and C2-ceramide was assessed. Shear-induced NO production was measured in arterioles using fluorescence microscopy. Hydrogen peroxide (H2O2) fluorescence was assessed in isolated human umbilical vein endothelial cells. Results Inhibition of NSmase in arterioles from otherwise healthy adults induced a switch from NO to H2O2-mediated flow-induced dilation within 30 minutes. In endothelial cells, NSmase inhibition acutely increased H2O2 production. Endothelial dysfunction in both models was prevented by treatment with C2-ceramide, S1P, and an agonist of S1P-receptor 1 (S1PR1), while the inhibition of S1P/S1PR1 signaling axis induced endothelial dysfunction. Ceramide increased NO production in arterioles from healthy adults, an effect that was diminished with inhibition of S1P/S1PR1/S1PR3 signaling. In arterioles from patients with CAD, inhibition of NSmase impaired dilation to flow. This effect was not restored with exogenous S1P. Although, inhibition of S1P/S1PR3 signaling impaired normal dilation to flow. Acute ceramide administration to arterioles from patients with CAD also promoted H2O2 as opposed to NO production, an effect dependent on S1PR3 signaling. Conclusion These data suggest that despite key differences in downstream signaling between health and disease, acute NSmase-mediated ceramide formation and its subsequent conversion to S1P is necessary for proper functioning of the human microvascular endothelium. As such, therapeutic strategies that aim to significantly lower ceramide formation may prove detrimental to the microvasculature.
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Affiliation(s)
- Gopika SenthilKumar
- Department of Physiology, Medical College of Wisconsin
- Cardiovasular Center, Medical College of Wisconsin
- Department of Anesthesiology, Medical College of Wisconsin
| | | | - Zachary Zirgibel
- Cardiovasular Center, Medical College of Wisconsin
- Department of Anesthesiology, Medical College of Wisconsin
| | - Brian Lindemer
- Cardiovasular Center, Medical College of Wisconsin
- Department of Anesthesiology, Medical College of Wisconsin
| | - Maria J. Jaramillo-Torres
- Cardiovasular Center, Medical College of Wisconsin
- Department of Anesthesiology, Medical College of Wisconsin
| | - Henry Bordas-Murphy
- Cardiovasular Center, Medical College of Wisconsin
- Department of Anesthesiology, Medical College of Wisconsin
| | - Mary E. Schulz
- Cardiovasular Center, Medical College of Wisconsin
- Department of Anesthesiology, Medical College of Wisconsin
| | - Paul J. Pearson
- Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin
| | - Julie K. Freed
- Department of Physiology, Medical College of Wisconsin
- Cardiovasular Center, Medical College of Wisconsin
- Department of Anesthesiology, Medical College of Wisconsin
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SenthilKumar G, Katunaric B, Bordas-Murphy H, Sarvaideo J, Freed JK. Estrogen and the Vascular Endothelium: The Unanswered Questions. Endocrinology 2023; 164:bqad079. [PMID: 37207450 PMCID: PMC10230790 DOI: 10.1210/endocr/bqad079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/03/2023] [Accepted: 05/17/2023] [Indexed: 05/21/2023]
Abstract
Premenopausal women have a lower incidence of cardiovascular disease (CVD) compared with their age-matched male counterparts; however, this discrepancy is abolished following the transition to menopause or during low estrogen states. This, combined with a large amount of basic and preclinical data indicating that estrogen is vasculoprotective, supports the concept that hormone therapy could improve cardiovascular health. However, clinical outcomes in individuals undergoing estrogen treatment have been highly variable, challenging the current paradigm regarding the role of estrogen in the fight against heart disease. Increased risk for CVD correlates with long-term oral contraceptive use, hormone replacement therapy in older, postmenopausal cisgender females, and gender affirmation treatment for transgender females. Vascular endothelial dysfunction serves as a nidus for the development of many cardiovascular diseases and is highly predictive of future CVD risk. Despite preclinical studies indicating that estrogen promotes a quiescent, functional endothelium, it still remains unclear why these observations do not translate to improved CVD outcomes. The goal of this review is to explore our current understanding of the effect of estrogen on the vasculature, with a focus on endothelial health. Following a discussion regarding the influence of estrogen on large and small artery function, critical knowledge gaps are identified. Finally, novel mechanisms and hypotheses are presented that may explain the lack of cardiovascular benefit in unique patient populations.
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Affiliation(s)
- Gopika SenthilKumar
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Cardiovasular Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee WI 53226, USA
| | - Boran Katunaric
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee WI 53226, USA
| | - Henry Bordas-Murphy
- Cardiovasular Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee WI 53226, USA
| | - Jenna Sarvaideo
- Divison of Endocrinology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Julie K Freed
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Cardiovasular Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee WI 53226, USA
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SenthilKumar G, Katunaric B, Bordas-Murphy H, Young M, Doren EL, Schulz ME, Widlansky ME, Freed JK. 17β-Estradiol promotes sex-specific dysfunction in isolated human arterioles. Am J Physiol Heart Circ Physiol 2023; 324:H330-H337. [PMID: 36607795 PMCID: PMC9925162 DOI: 10.1152/ajpheart.00708.2022] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 01/07/2023]
Abstract
Despite data showing that estrogen is vasculoprotective in large conduit arteries, hormone therapy (HT) during menopause has not proven to mitigate cardiovascular disease (CVD) risk. Estrogen exposure through prolonged oral contraceptive use and gender-affirming therapy can also increase cis- and trans-females' risk for future CVD, respectively. The microvasculature is a unique vascular bed that when dysfunctional can independently predict future adverse cardiac events; however, studies on the influence of estrogen on human microvessels are limited. Here, we show that isolated human arterioles from females across the life span maintain nitric oxide (NO)-mediated dilation to flow, whereas chronic (16-20 h) exposure to exogenous (100 nM) 17β-estradiol promotes microvascular endothelial dysfunction in vessels from adult females of <40 and ≥40 yr of age. The damaging effect of estrogen was more dramatic in arterioles from biological males, as they exhibited both endothelial and smooth muscle dysfunction. Furthermore, females of <40 yr have greater endothelial expression of estrogen receptor-β (ER-β) and G protein-coupled estrogen receptor (GPER) compared with females of ≥40 yr and males. Estrogen receptor-α (ER-α), the prominent receptor associated with protective effects of estrogen, was identified within the adventitia as opposed to the endothelium across all groups. To our knowledge, this is the first study to report the detrimental effects of estrogen on the human microvasculature and highlights differences in estrogen receptor expression.NEW & NOTEWORTHY Microvascular dysfunction is an independent predictor of adverse cardiac events; however, the effect of estrogen on the human microcirculation represents a critical knowledge gap. To our knowledge, this is the first study to report sex-specific detrimental effects of chronic estrogen on human microvascular reactivity. These findings may offer insight into the increased CVD risk associated with estrogen use in both cis- and trans-females.
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Affiliation(s)
- Gopika SenthilKumar
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Boran Katunaric
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Henry Bordas-Murphy
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Micaela Young
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Erin L Doren
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Mary E Schulz
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Michael E Widlansky
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Pharmacology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Julie K Freed
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
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Katunaric B, SenthilKumar G, Schulz ME, De Oliveira N, Freed JK. S1P (Sphingosine-1-Phosphate)-Induced Vasodilation in Human Resistance Arterioles During Health and Disease. Hypertension 2022; 79:2250-2261. [PMID: 36070401 PMCID: PMC9473289 DOI: 10.1161/hypertensionaha.122.19862] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Preclinical studies suggest that S1P (sphingosine-1-phosphate) influences blood pressure regulation primarily through NO-induced vasodilation. Because microvascular tone significantly contributes to mean arterial pressure, the mechanism of S1P on human resistance arterioles was investigated. We hypothesized that S1P induces NO-mediated vasodilation in human arterioles from adults without coronary artery disease (non-coronary artery disease) through activation of 2 receptors, S1PR1 (S1P receptor 1) and S1PR3 (S1P receptor 3). Furthermore, we tested whether this mechanism is altered in vessels from patients diagnosed with coronary artery disease. METHODS Human arterioles (50-200 µm in luminal diameter) were dissected from otherwise discarded surgical adipose tissue, cannulated, and pressurized. Following equilibration, resistance vessels were preconstricted with ET-1 (endothelin-1) and changes in internal diameter to increasing concentrations of S1P (10-12 to 10-7 M) in the presence or absence of various inhibitors were measured. RESULTS S1P resulted in significant dilation that was abolished in vessels treated with S1PR1 and S1PR3 inhibitors and in vessels with reduced expression of each receptor. Dilation to S1P was significantly reduced in the presence of the NOS (NO synthase) inhibitor Nω-nitro-L-arginine methyl ester and the NO scavenger 2-4-(carboxyphenyl)-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide. Interestingly, dilation was also significantly impaired in the presence of PEG-catalase (polyethylene glycol-catalase), apocynin, and specific inhibitors of NOX (NADPH oxidases) 2 and 4. Dilation in vessels from patients diagnosed with coronary artery disease was dependent on H2O2 alone which was only dependent on S1PR3 activation. CONCLUSIONS These translational studies highlight the inter-species variation observed in vascular signaling and provide insight into the mechanism by which S1P regulates microvascular resistance and ultimately blood pressure in humans.
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Affiliation(s)
- Boran Katunaric
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI
| | - Gopika SenthilKumar
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI
| | - Mary E. Schulz
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI
| | - Nilto De Oliveira
- Department of Surgery, Division of Adult Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Julie K. Freed
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI
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Schulz ME, Hockenberry JC, Katunaric B, Pagel PS, Freed JK. Blockade of endothelial Mas receptor restores the vasomotor response to phenylephrine in human resistance arterioles pretreated with captopril and exposed to propofol. BMC Anesthesiol 2022; 22:240. [PMID: 35906533 PMCID: PMC9336100 DOI: 10.1186/s12871-022-01786-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background Hypotension that is resistant to phenylephrine is a complication that occurs in anesthetized patients treated with angiotensin converting enzyme (ACE) inhibitors. We tested the hypothesis that Ang 1–7 and the endothelial Mas receptor contribute to vasodilation produced by propofol in the presence of captopril. Methods The internal diameters of human adipose resistance arterioles were measured before and after administration of phenylephrine (10–9 to 10–5 M) in the presence and absence of propofol (10–6 M; added 10 min before the phenylephrine) or the Mas receptor antagonist A779 (10–5 M; added 30 min before phenylephrine) in separate experimental groups. Additional groups of arterioles were incubated for 16 to 20 h with captopril (10–2 M) or Ang 1–7 (10–9 M) before experimentation with phenylephrine, propofol, and A779. Results Propofol blunted phenylephrine-induced vasoconstriction in normal vessels. Captopril pretreatment alone did not affect vasoconstriction, but the addition of propofol markedly attenuated the vasomotor response to phenylephrine. A779 alone did not affect vasoconstriction in normal vessels, but it restored vasoreactivity in arterioles pretreated with captopril and exposed to propofol. Ang 1–7 reduced the vasoconstriction in response to phenylephrine. Addition of propofol to Ang 1–7-pretreated vessels further depressed phenylephrine-induced vasoconstriction to an equivalent degree as the combination of captopril and propofol, but A779 partially reversed this effect. Conclusions Mas receptor activation by Ang 1–7 contributes to phenylephrine-resistant vasodilation in resistance arterioles pretreated with captopril and exposed to propofol. These data suggest an alternative mechanism by which refractory hypotension may occur in anesthetized patients treated with ACE inhibitors.
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Affiliation(s)
- Mary E Schulz
- Department of Anesthesiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.,Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Joseph C Hockenberry
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.,Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Boran Katunaric
- Department of Anesthesiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.,Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Paul S Pagel
- Anesthesiology Service, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI, 53295, USA
| | - Julie K Freed
- Department of Anesthesiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA. .,Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, 53226, USA. .,Department of Physiology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
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SenthilKumar G, Heisner JS, Schlaak R, Mishra J, Katunaric B, Camara AK, Bergom C. What Doesn't Kill You Makes You Stronger—Even Heart Radiation? FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.00r89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Gopika SenthilKumar
- Department of PhysiologyMedical College of WisconsinWauwatosaWI
- Department of AnesthesiologyMedical College of WisconsinWauwatosaWI
| | - James S. Heisner
- Department of AnesthesiologyMedical College of WisconsinWauwatosaWI
| | - Rachel Schlaak
- Department of Pharmacology and ToxicologyMedical College of WisconsinWauwatosaWI
| | - Jyotsna Mishra
- Department of AnesthesiologyMedical College of WisconsinWauwatosaWI
| | - Boran Katunaric
- Department of AnesthesiologyMedical College of WisconsinWauwatosaWI
| | - Amadou K. Camara
- Department of AnesthesiologyMedical College of WisconsinWauwatosaWI
| | - Carmen Bergom
- Department of Pharmacology and ToxicologyMedical College of WisconsinWauwatosaWI
- Department of Radiation OncologyMedical College of WisconsinWauwatosaWI
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SenthilKumar G, Katunaric B, Bordas‐Murphy H, Young M, Buiter NJ, Freed JK. Is Estrogen a Friend or Foe of the Human Microcirculation Throughout the Lifespan? FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r2290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Gopika SenthilKumar
- Department of PhysiologyMedical College of WisconsinWauwatosaWI
- Department of AnesthesiologyMedical College of WisconsinWauwatosaWI
| | - Boran Katunaric
- Department of AnesthesiologyMedical College of WisconsinWauwatosaWI
| | | | - Micaela Young
- Department of MedicineMedical College of WisconsinWauwatosaWI
| | - Nicole J. Buiter
- Department of AnesthesiologyMedical College of WisconsinWauwatosaWI
| | - Julie K. Freed
- Department of PhysiologyMedical College of WisconsinWauwatosaWI
- Department of AnesthesiologyMedical College of WisconsinWauwatosaWI
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Katunaric B, SenthilKumar G, Schulz ME, Freed JK. Role of NOX2 in Ceramide‐Induced Human Microvascular Endothelial Dysfunction. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r4005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Boran Katunaric
- Anesthesiology, Cardiovascular CenterMedical College of WisconsinMilwaukeeWI
- Cardiovascular CenterMedical College of WisconsinMilwaukeeWI
| | - Gopika SenthilKumar
- Cardiovascular CenterMedical College of WisconsinMilwaukeeWI
- AnesthesiologyMedical College of WisconsinMilwaukeeWI
- PhysiologyMedical College of WisconsinMilwaukeeWI
| | - Mary E. Schulz
- Cardiovascular CenterMedical College of WisconsinMilwaukeeWI
- AnesthesiologyMedical College of WisconsinMilwaukeeWI
| | - Julie K. Freed
- Cardiovascular CenterMedical College of WisconsinMilwaukeeWI
- AnesthesiologyMedical College of WisconsinMilwaukeeWI
- PhysiologyMedical College of WisconsinMilwaukeeWI
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SenthilKumar G, Katunaric B, Bordas-Murphy H, Schulz ME, Freed JK. Abstract 470: Sphingosine-1-Phosphate Signaling In The Human Microvascular Endothelium During Health And Disease. Arterioscler Thromb Vasc Biol 2022. [DOI: 10.1161/atvb.42.suppl_1.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The loss of nitric oxide (NO)-mediated flow-induced dilation (FID) in the microvasculature, or microvascular endothelial dysfunction, is strongly linked to future cardiovascular events. Our lab has previously shown that chronic inhibition of sphingosine-1-phosphate (S1P) formation induces the change in FID mediator from the vasoprotective NO to the pro-inflammatory, pro-atherosclerotic hydrogen peroxide. The same transition is observed in arterioles from patients with coronary artery disease (CAD). Since S1P promotes NO-mediated FID, we hypothesized that formation of S1P and activation of S1P receptor 1 (S1PR1) is critical for FID in microvessels from healthy adults as opposed to arterioles from patients with CAD. Videomicroscopy was used to perform vascular function studies on human resistance arterioles (100-250μm) dissected from discarded surgical adipose tissue. The vessels were pre-constricted with endothelin-1 and changes in internal diameter in response to flow was measured. In arterioles from healthy adults, treatment with a sphingosine kinase (SpK) inhibitor for 30 minutes abolished FID (7.7±8.0% of maximal dilator capacity, n=3; mean±SEM) compared to control (73.1±8.2% n=9, p<0.05; *two-way ANOVA), whereas inhibition of S1PR1 appeared to delay the response to dilation (19.1±10.5% vs. 52.8±9.0% at 20mmHg pressure gradient, p<0.05*). In microvessels from patients with disease, both inhibition of SpK (91.8±2.8%, n=5) and S1PR1 (72.5±6.4%, n=6) did not affect FID compared to control (90.9±2.4%, n=4). Interestingly, S1PR1 expression was similar in CAD and nonCAD arterioles. Together these data suggest that formation of S1P and potentially the activation of S1PR1 is critical for FID during health, however this pathway does not contribute to FID during disease. We conclude that while arterioles can compensate for loss of this pathway in disease to maintain tissue perfusion, formation of S1P and activation of its receptors may be necessary to promote NO formation during shear and may serve as potential targets to prevent future cardiovascular disease.
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Cohen KE, Katunaric B, Schulz ME, SenthilKumar G, Young MS, Mace JE, Freed JK. Role of Adiponectin Receptor 1 in Promoting Nitric Oxide-Mediated Flow-Induced Dilation in the Human Microvasculature. Front Pharmacol 2022; 13:875900. [PMID: 35444544 PMCID: PMC9014203 DOI: 10.3389/fphar.2022.875900] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/21/2022] [Indexed: 12/12/2022] Open
Abstract
Chronic administration of exogenous adiponectin restores nitric oxide (NO) as the mediator of flow-induced dilation (FID) in arterioles collected from patients with coronary artery disease (CAD). Here we hypothesize that this effect as well as NO signaling during flow during health relies on activation of Adiponectin Receptor 1 (AdipoR1). We further posit that osmotin, a plant-derived protein and AdipoR1 activator, is capable of eliciting similar effects as adiponectin. Human arterioles (80-200 μm) collected from discarded surgical adipose specimens were cannulated, pressurized, and pre-constricted with endothelin-1 (ET-1). Changes in vessel internal diameters were measured during flow using videomicroscopy. Immunofluorescence was utilized to compare expression of AdipoR1 during both health and disease. Administration of exogenous adiponectin failed to restore NO-mediated FID in CAD arterioles treated with siRNA against AdipoR1 (siAdipoR1), compared to vessels treated with negative control siRNA. Osmotin treatment of arterioles from patients with CAD resulted in a partial restoration of NO as the mediator of FID, which was inhibited in arterioles with decreased expression of AdipoR1. Together these data highlight the critical role of AdipoR1 in adiponectin-induced NO signaling during shear. Further, osmotin may serve as a potential therapy to prevent microvascular endothelial dysfunction as well as restore endothelial homeostasis in patients with cardiovascular disease.
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Affiliation(s)
- Katie E. Cohen
- Department of Medicine-Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Boran Katunaric
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Mary E. Schulz
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Gopika SenthilKumar
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Micaela S. Young
- Department of Medicine-Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - James E. Mace
- Department of Surgery-Division of Adult Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Julie K. Freed
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI, United States
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Abstract
Cardiovascular disease risk increases with age regardless of sex. Some of this risk is attributable to alterations in natural hormones throughout the life span. The quintessential example of this being the dramatic increase in cardiovascular disease following the transition to menopause. Plasma levels of adiponectin, a "cardioprotective" adipokine released primarily by adipose tissue and regulated by hormones, also fluctuate throughout one's life. Plasma adiponectin levels increase with age in both men and women, with higher levels in both pre- and postmenopausal women compared with men. Younger cohorts seem to confer cardioprotective benefits from increased adiponectin levels yet elevated levels in the elderly and those with existing heart disease are associated with poor cardiovascular outcomes. Here, we review the most recent data regarding adiponectin signaling in the vasculature, highlight the differences observed between the sexes, and shed light on the apparent paradox regarding increased cardiovascular disease risk despite rising plasma adiponectin levels over time.
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Affiliation(s)
- Katie E. Cohen
- 1Division of Cardiology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin,5Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Boran Katunaric
- 2Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin,5Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Gopika SenthilKumar
- 2Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin,3Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin,5Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jennifer J. McIntosh
- 3Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin,4Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin,5Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Julie K. Freed
- 2Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin,3Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin,5Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin
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Katunaric B, Stehula F, Schulz M, Gutterman D, Freed J. Human Microvascular Reactivity
In Vivo
Using Incident Dark Field Videomicroscopy. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.03111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Boran Katunaric
- Department of AnesthesiologyCardiovascular CenterMedical College of WisconsinMilwaukeeWI
| | | | - Mary Schulz
- Department of AnesthesiologyCardiovascular CenterMedical College of WisconsinMilwaukeeWI
| | - David Gutterman
- Department of Medicine ‐Division of CardiologyCardiovascular CenterMedical College of WisconsinMilwaukeeWI
| | - Julie Freed
- Department of AnesthesiologyCardiovascular CenterMedical College of WisconsinMilwaukeeWI
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Schulz M, Katunaric B, Cohen K, Gutterman D, Freed J. Investigation of the Dual Functional Role of Ceramide in the Human Microcirculation. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.03010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mary Schulz
- AnesthesiologyMedical College of WisconsinMilwaukeeWI
- Cardiovascular CenterMedical College of WisconsinMilwaukeeWI
| | - Boran Katunaric
- AnesthesiologyMedical College of WisconsinMilwaukeeWI
- Cardiovascular CenterMedical College of WisconsinMilwaukeeWI
| | - Katie Cohen
- Cardiovascular CenterMedical College of WisconsinMilwaukeeWI
- MedicineMedical College of WisconsinMilwaukeeWI
| | - David Gutterman
- Cardiovascular CenterMedical College of WisconsinMilwaukeeWI
- MedicineMedical College of WisconsinMilwaukeeWI
| | - Julie Freed
- Cardiovascular CenterMedical College of WisconsinMilwaukeeWI
- Medical College of WisconsinMilwaukeeWI
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Katunaric B, Schulz M, Freed J. Investigation of Sphingosine‐1‐Phosphate‐induced Vasodilation in the Human Microvasculature. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.03061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Boran Katunaric
- Department of AnesthesiologyCardiovascular CenterMedical College of WisconsinMilwaukeeWI
| | - Mary Schulz
- Department of AnesthesiologyCardiovascular CenterMedical College of WisconsinMilwaukeeWI
| | - Julie Freed
- Department of AnesthesiologyCardiovascular CenterMedical College of WisconsinMilwaukeeWI
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Katunaric B, Cohen KE, Beyer AM, Gutterman DD, Freed JK. Sweat the small stuff: The human microvasculature and heart disease. Microcirculation 2021; 28:e12658. [PMID: 32939881 PMCID: PMC7960576 DOI: 10.1111/micc.12658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/13/2020] [Accepted: 09/07/2020] [Indexed: 01/09/2023]
Abstract
Traditionally thought of primarily as the predominant regulator of myocardial perfusion, it is becoming more accepted that the human coronary microvasculature also exerts a more direct influence on the surrounding myocardium. Coronary microvascular dysfunction (CMD) not only precedes large artery atherosclerosis, but is associated with other cardiovascular diseases such as heart failure with preserved ejection fraction and hypertrophic cardiomyopathy. It is also highly predictive of cardiovascular events in patients with or without atherosclerotic cardiovascular disease. This review focuses on this recent paradigm shift and delves into the clinical consequences of CMD. Concepts of how resistance arterioles contribute to disease will be discussed, highlighting how the microvasculature may serve as a potential target for novel therapies and interventions. Finally, both invasive and non-invasive methods with which to assess the coronary microvasculature both for diagnostic and risk stratification purposes will be reviewed.
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Affiliation(s)
- Boran Katunaric
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Katie E. Cohen
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Medicine-Division of Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Andreas M. Beyer
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Medicine-Division of Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - David D. Gutterman
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Medicine-Division of Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Julie K. Freed
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA
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Katunaric B, Schulz ME, Freed JK. Sphingosine‐1‐Phosphate Receptor 1 Mediated Vasodilation in Human Arterioles. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.03714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Schulz ME, Katunaric B, Hockenberry JC, Gutterman DD, Freed JK. Manipulation of the Sphingolipid Rheostat Influences the Mediator of Flow-Induced Dilation in the Human Microvasculature. J Am Heart Assoc 2019; 8:e013153. [PMID: 31462128 PMCID: PMC6755855 DOI: 10.1161/jaha.119.013153] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 07/25/2019] [Indexed: 12/26/2022]
Abstract
Background Elevated levels of ceramide, a sphingolipid known to cause a transition from nitric oxide (NO)- to hydrogen peroxide-dependent flow-induced dilation (FID) in human arterioles, correlate with adverse cardiac events. However, elevations of ceramide are associated with changed concentrations of other sphingolipid metabolites. The effects of sphingolipid metabolites generated through manipulation of this lipid pathway on microvascular function are unknown. We examined the hypothesis that inhibition or activation of the ceramide pathway would determine the mediator of FID. Methods and Results Using videomicroscopy, internal diameter changes were measured in human arterioles collected from discarded adipose tissue during surgery. Inhibition of neutral ceramidase, an enzyme responsible for the hydrolysis of ceramide, favored hydrogen peroxide-dependent FID in arterioles from healthy patients. Using adenoviral technology, overexpression of neutral ceramidase in microvessels from diseased patients resulted in restoration of NO-dependent FID. Exogenous sphingosine-1-phosphate, a sphingolipid with opposing effects of ceramide, also restored NO as the mediator of FID in diseased arterioles. Likewise, exogenous adiponectin, a known activator of neutral ceramidase, or, activation of adiponectin receptors, favored NO-dependent dilation in arterioles collected from patients with coronary artery disease. Conclusions Sphingolipid metabolites play a critical role in determining the mediator of FID in human resistance arterioles. Manipulating the sphingolipid balance towards ceramide versus sphingosine-1-phosphate favors microvascular dysfunction versus restoration of NO-mediated FID, respectively. Multiple targets exist within this biolipid pathway to treat microvascular dysfunction and potentially improve patient outcomes.
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Affiliation(s)
- Mary E. Schulz
- Department of AnesthesiologyMedical College of WisconsinMilwaukeeWI
- Cardiovascular CenterMedical College of WisconsinMilwaukeeWI
| | - Boran Katunaric
- Department of AnesthesiologyMedical College of WisconsinMilwaukeeWI
- Cardiovascular CenterMedical College of WisconsinMilwaukeeWI
| | - Joseph C. Hockenberry
- Cardiovascular CenterMedical College of WisconsinMilwaukeeWI
- Division of CardiologyDepartment of MedicineMedical College of WisconsinMilwaukeeWI
| | - David D. Gutterman
- Cardiovascular CenterMedical College of WisconsinMilwaukeeWI
- Division of CardiologyDepartment of MedicineMedical College of WisconsinMilwaukeeWI
| | - Julie K. Freed
- Department of AnesthesiologyMedical College of WisconsinMilwaukeeWI
- Cardiovascular CenterMedical College of WisconsinMilwaukeeWI
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