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Bartoli-Leonard F, Rogers M, Zheng K, Small A, Asano T, Kuraoka S, Blaser M, Natarajan P, Yeang C, Tsimikas S, O'donnell C, Aikawa M, Singh S, Stroes E, Aikawa E. Inhibition of novel lipoprotein(a) receptor major facilitator superfamily domain containing 5 (MFSD5) reduces development of aortic valve calcification. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.139] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): Private grant from Kowa Pharmaceuticals to Brigham and Woman's Hospital
Calcific aortic valve stenosis (CAVS) is the most prevent valvular heart disease in the western world increasing exponentially with age, with an 112% increase in CAVS deaths in the last three decades; however no therapeutic treatment is currently available. Recently, lipoprotein(a) [Lp(a)] has been demonstrated to be an independent and causal risk factor for CAVS, yet the understanding of its cellular uptake and catabolism is limited thus underscoring the need for further investigation.
This study aimed to determine a target receptor, unique for Lp(a) on the surface of valvular interstitial cells (VICs) and ascertain the role of the receptor on the development of VIC calcification.
Unbiased ligand-receptor capture mass spectrometry (TriCEPS) was used to identify target receptor, with western blotting, ELISA, qPCR, alizarin red calcium staining and immunofluorescence used to validate the targets in vitro via siRNA inhibition and overexpression. Transmission electron microscopy (TEM) was used to determine uptake of Lp(a) within excised human valves. Identification of small molecule inhibitors was assessed computationally via the L1000 dataset, with the top hit candidate validated in vitro. Genotype-phenotype studies were examined using the United Kingdom Biobank (UKBB) and the Millions Veterans Program. Linear regression was used to evaluate association between aortic stenosis and plasma Lp(a) levels, and a phenotype-wide association analysis was then performed against this generated ‘genotype’.
Ligand-receptor capture mass spectrometry was used to detect novel membrane proteins with specific binding to Lp(a); MFSD5, MRC2, LDLR were identified as possible candidates. MFSD5 RNAscope demonstrated its presence in human aortic valves. Lp(a) uptake in VICs was confirmed via western blot and TEM. MFSD5 siRNA significantly reduced dil-labelled Lp(a) uptake in human VICs (p=0.003) and HEPG2 cells (p=0.0003), conversely MFSD5 overexpression increased uptake (p=0.0345, p=0.0318), whilst specificity of MFSD5 to Lp(a) alone was shown via no change in LDL uptake following MFSD5 inhibition (p=0.616, p=0.991). MFSD5 inhibition reduced RUNX2 (p=0.0124) and Osteocalcin (p<0.001) RNA expression and reduced alizarin red staining following culture in Lp(a) osteogenic media for 21 days (p<0.0033). Druggability of MFSD5 was confirmed by the L1000 database, which identified aminopurvalanol as a binding partner for MFSD5 and significantly reduced Lp(a) uptake within VICs (p=0.0091). MFSD5-loss of function within the UKBB showed no significant cardiovascular association, however 50kb +/- of the MFSD5 gene showed nominal association with hyperlipidaemia and atrial fibrillation.
The current study demonstrates the novel Lp(a) receptor MFSD5 may be responsible for uptake of Lp(a) within VICs, resulting in the development of aortic valve calcification, highlighting the need for further exploration into the role of MFSD5 in aortic valve disease.
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Affiliation(s)
- F Bartoli-Leonard
- Brigham And Women'S Hospital, Harvard Medical School , Boston , United States of America
| | - M Rogers
- Brigham And Women'S Hospital, Harvard Medical School , Boston , United States of America
| | - K Zheng
- Brigham And Women'S Hospital, Harvard Medical School , Boston , United States of America
| | - A Small
- Brigham And Women'S Hospital, Harvard Medical School , Boston , United States of America
| | - T Asano
- Brigham And Women'S Hospital, Harvard Medical School , Boston , United States of America
| | - S Kuraoka
- Brigham And Women'S Hospital, Harvard Medical School , Boston , United States of America
| | - M Blaser
- Brigham And Women'S Hospital, Harvard Medical School , Boston , United States of America
| | - P Natarajan
- Boston VA Healthcare System , Boston , United States of America
| | - C Yeang
- University of California, San Diego , San Diego , United States of America
| | - S Tsimikas
- University of California, San Diego , San Diego , United States of America
| | - C O'donnell
- Boston VA Healthcare System , Boston , United States of America
| | - M Aikawa
- Brigham And Women'S Hospital, Harvard Medical School , Boston , United States of America
| | - S Singh
- Brigham And Women'S Hospital, Harvard Medical School , Boston , United States of America
| | - E Stroes
- Amsterdam UMC - Location Academic Medical Center , Amsterdam , Netherlands (The)
| | - E Aikawa
- Brigham And Women'S Hospital, Harvard Medical School , Boston , United States of America
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Schnitzler J, Hoogeveen R, Ali L, Prange K, Weeghel M, Versloot M, Waissi F, Houtkooper R, De Kleijn D, De Winther M, Koschinsky M, Tsimikas S, Witztum J, Stroes E, Kroon J. Atherogenic lipoprotein(A) increases vascular glycolysis, thereby facilitating inflammation and leukocyte extravasation. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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3
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Dzobo K, Waissi F, Winkelmeijer M, De Kleijn D, Stroes E, Kroon J. Phenotyping carotid endarterectomy plaques of patients with elevated levels of lipoprotein(A). Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.044] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pavanello C, Zheng K, Schnitzler J, Kroon J, Versloot M, Levels J, Van Tuijl J, Riksen N, Stroes E, Calabresi L, Bekkering S. Effects of APOA1, ABCA1 and LCAT mutations on monocyte activation in humans – a double edged sword. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.088] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Waissi F, Timmerman N, Dekker M, Hoogeveen R, Schnitzler J, De Borst G, Stroes E, De Kleijn D, Kroon J. Elevated lipoprotein(a) levels increase risk of secondary major adverse cardiovascular events in patients undergoing carotid endarterectomy. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.449] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Dzobo K, Stiekema L, Cupido A, Pereira JB, Zhang X, Prange K, M. de winther, Stroes E, Bahjat M. Identification Of The Key Molecular Events Triggered By Lipoprotein (A) In Peripheral Monocytes. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.708] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Verweij S, Stiekema L, Delewi R, Zheng K, Bernelot Moens S, Kroon J, Versloot M, Piek J, Verberne H, Stroes E. Prolonged hematopoietic and myeloid cellular response in patients after a myocardial infarction measured with 18F-DPA-714 PET/CT. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.103] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bahjat M, Nicorescu I, Hoogeveen R, Bekkering S, Kroon J, Stroes E. Identification of the key molecular events triggered by lipoprotein (a) in peripheral monocytes. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.896] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Verweij S, Moens SB, Kroon J, Schnitzler J, Stroes E. Increased arterial wall inflammation in patients with familial dysbetalipoproteinemia. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.021] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zheng K, Bernelot Moens S, van Leuven S, Havik S, Baeten D, Stroes E. Increasing B1a lymphocytes through APRIL overexpression in apolipoprotein E-deficient mice stabilizes advanced atherosclerotic lesions by decreasing necrotic area and increasing smooth muscle cell content. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Stroes E, Benghozi R, Dasseux J, Genest J, Ginsberg H, Keyserling C, Leitersdorf E, Raggi P, von Eckardstein A. A phase III multicentre, double-blind, placebo-controlled study (TANGO) to evaluate CER-001 on carotid atherosclerosis (vessel wall area) in patients with familial primary hypoalphalipoproteinaemia. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.609] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Stroes E, Robinson J, Raal F, Dufour R, Sullivan D, Blagden M, Kassahun H, Yang J, Wasserman S, Koren M. CLINICAL EQUIVALENCE OF EVOLOCUMAB AMONG PATIENT SUBGROUPS IN PROFICIO: A POOLED ANALYSIS OF 3146 PATIENTS FROM PHASE 3 STUDIES. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Steinhagen-Thiessen E, Stroes E, Soran H, Johnson C, Iotti G, Zibellini M, Ossenkoppele B, Dippel M, Averna M. First global, longitudinal, pharmaco-epidemiologic, observational registry on gene therapy in the management of lipoprotein lipase deficiency (GENIALL). Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sandberg M, Barbaras R, van Vught D, Keijserling C, Dasseux J, Verberne H, Smits L, Dongen G, Stroes E. The effect of labelling apolipoprotein (apo) a-1 with the radio-isotope 89zr on cholesterol mobilization in vitro and in vivo. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.536] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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van der Valk F, Kroon J, Thurlings R, Verberne H, Nederveen A, van Buul J, Nieuwdorp M, Mulder W, Fayad Z, Stroes E. Non-invasive in vivo imaging of peripheral mononuclear cell migration to atherosclerosis in humans. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.026] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Gaudet D, Stroes E, Bruno M, Andersen M, Petry H, Meyer C. Gene therapy with alipogene tiparvovec (glybera®) for the prevention of LPLD induced pancreatitis: Follow-up data suggests long-term clinical benefit. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mulders T, Bogaard BV, Bakker A, Trip M, Stroes E, Born BV, Pinto-Sietsma S. 853 ARTERIAL STIFFNESS IN FAMILIES WITH PREMATURE CORONARY ARTERY DISEASE. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70854-6] [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: 10/18/2022]
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Mulders T, Sivapalaratnam S, Stroes E, Guerci A, Pinto-Sietsma S. 773 ASYMPTOMATIC SUBJECTS WITH A POSITIVE FAMILY HISTORY FOR PREMATURE CORONARY ARTERY DISEASE BENEFIT FROM PREVENTIVE TREATMENT: A POST-HOC ANALYSIS. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70774-7] [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: 10/18/2022]
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Greentree S, Gaudet D, Stroes E, van den Bulk N, de Wal J. Gene therapy with alipogene tiparvovec benefits lipoprotein lipase deficiency (LPLD) patients with pancreatitis history. Atherosclerosis 2010. [DOI: 10.1016/j.atherosclerosis.2010.07.039] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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de Groot E, Duivenvoorden R, Stroes E, Kastelein J. Abstract: 541 IMAGING CAROTID ATHEROSCLEROSIS. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70079-0] [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: 10/20/2022]
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Broekhuizen L, Meuwese M, Mooij H, Lemkes B, Gouverneur M, Tang M, Verberne H, Nieuwdorp M, Vink H, Stroes E. Abstract: P215 EFFECT OF SULODEXIDE ON ENDOTHELIAL GLYCOCALYX AND VASCULAR PERMEABILITY IN PATIENTS WITH TYPE II DIABETES MELLITUS. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70522-7] [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: 10/20/2022]
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Franssen R, Kastelein J, Stroes E, Dallinga-Thie G, Kuivenhoven J. Abstract: P423 AN INFLAMMATORY STATE AS OBSERVED IN PATIENTS WITH SEPSIS AND CROHN'S DISEASE DOES NOT AFFECT ABCA-1 MEDIATED CHOLESTEROL EFFLUX. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70718-4] [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: 11/25/2022]
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Holleboom A, Stroes E, Kastelein J, Defesche J, Kuivenhoven J, Hollak C. Abstract: P365 LOSS OF DISULFIDE BOND IN LECITHIN:CHOLESTEROL ACYL TRANSFERASE DUE TO A CYS313—>TYR MUTATION CAUSES FAMILIAL LCAT DEFICIENCY IN A PATIENT OF MOROCCAN DESCENT. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70660-9] [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: 10/20/2022]
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Duivenvoorden R, de Groot E, VanBavel E, Stroes E, Lameris J, Kastelein J, Nederveen A. Abstract: 608 WALL SHEAR STRESS CORRELATES WITH THE ELASTICITY AND THICKNESS OF THE CAROTID ARTERY WALL: A 3.0 TESLA MRI STUDY. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70355-1] [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: 11/28/2022]
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Abstract
The endothelial glycocalyx exerts a wide array of vasculoprotective effects via inhibition of coagulation and leucocyte adhesion, by contributing to the vascular permeability barrier and by mediating shear stress-induced NO release. In this review, we will focus on the relationship between fluid shear stress and the endothelial glycocalyx. We will address the hypothesis that modulation of glycocalyx synthesis by fluid shear stress may contribute to thinner glycocalyces, and therefore more vulnerable endothelium, at lesion-prone sites of arterial bifurcations. Finally, we will discuss the effects of known atherogenic stimuli such as hyperglycaemia on whole body glycocalyx volume in humans and its effect on endothelial function.
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Affiliation(s)
- M Gouverneur
- Department of Medical Physics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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Butzelaar J, Duivenvoorden R, Elsen B, Draijer R, van Roon A, Stroes E, Kastelein J, de Groot E. M.475 Repeatability of brachial FMD measurements in healthy adults and power calculation for studies. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90473-x] [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: 10/26/2022]
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Abstract
It is increasingly recognized that folates may play a role in the prevention of cardiovascular disease. Over the last few years, several studies have reported beneficial effects of folates on endothelial function, a surrogate end point for cardiovascular risk. Consistently, observational studies have demonstrated an association between folate levels and cardiovascular morbidity and mortality. The exact mechanisms underlying the ameliorative effects of folates on the endothelium remain to be elucidated. Thus far, most studies have focused on the homocysteine-lowering effects of folates. However, recently, benefits of folates independent of homocysteine lowering have also been reported. Potential mechanisms include antioxidant actions, effects on cofactor availability, or direct interactions with the enzyme endothelial NO synthase. Obviously, beneficial effects of folates on cardiovascular risk would have important clinical and dietary consequences. However, for definite conclusions, the completion of ongoing randomized controlled trials will have to be awaited.
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Affiliation(s)
- M C Verhaar
- Department of Vascular Medicine, University Medical Centre Utrecht, Utrecht, the Netherlands.
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Rabelink TJ, Stroes E. Atherosclerosis: defeat of the defense? Circ Res 2001; 88:456-7. [PMID: 11249866 DOI: 10.1161/01.res.88.5.456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wever R, Boer P, Hijmering M, Stroes E, Verhaar M, Kastelein J, Versluis K, Lagerwerf F, van Rijn H, Koomans H, Rabelink T. Nitric oxide production is reduced in patients with chronic renal failure. Arterioscler Thromb Vasc Biol 1999; 19:1168-72. [PMID: 10323766 DOI: 10.1161/01.atv.19.5.1168] [Citation(s) in RCA: 162] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In patients with chronic renal failure (CRF), atherosclerosis is a major cause of cardiovascular morbidity and mortality. Generally, atherosclerosis has been associated with a reduced bioavailability of nitric oxide (NO). Experimental studies have indicated the presence of enhanced NO degradation by reactive oxygen species as well as decreased NO production as possible causes for this reduced NO bioavailability. So far, the question whether or not NO production is impaired in patients with CRF has never been investigated. Therefore, we measured whole body NO production in 7 patients with CRF, and in 7 matched healthy subjects. To assess the relative importance of a dysfunction of NO synthase (NOS), we compared the NO production of these patients to that of 2 other groups known to have endothelial dysfunction, ie, 7 patients with familial hypercholesterolemia (FH) who did not yet have signs of clinical cardiovascular disease (all nonsmokers), and 5 cigarette smokers. These groups were also compared with 7 nonsmoking, age-matched healthy subjects. Whole body NO production, determined as in vivo arginine-to-citrulline conversion, was assessed by giving an intravenous infusion of [15N2]-arginine as a substrate for NOS and measuring isotopic plasma enrichment of [15N]-citrulline by LC-MS. NO production in the CRF patients (0.13+/-0.02 micromol. kg-1. h-1) was significantly lower (P<0.05) than in the corresponding control group (0.23+/-0.09 micromol. kg-1. h-1). NO production also tended to be lower in the FH patients (0.16+/-0.04 micromol. kg-1. h-1), but the difference with the corresponding control group did not reach significance (0.22+/-0.06 micromol. kg-1. h-1). In the group of smokers, NO production was similar to that in nonsmokers (0. 22+/-0.09 micromol. kg-1. h-1). In conclusion, it is demonstrated for the first time that basal whole body NO production is reduced in patients with CRF. This finding implies that therapeutic interventions to endothelial dysfunction in these patients should be primarily directed toward improvement of NO production. The finding of only a tendency toward reduction of NO production in patients with FH and the absence of a reduction in cigarette smokers suggests that other mechanisms such as enhanced NO degradation may be involved in the decrease of NO bioavailability in these groups.
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Affiliation(s)
- R Wever
- Department of Clinical Chemistry, University Hospital Utrecht, The Netherlands
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Abstract
Using fluorescence optical and electron spin resonance spectroscopy, we have investigated the production of superoxide by bovine endothelial nitric oxide synthase (NOS). In contrast to neuronal NOS, the heme moiety is identified as the exclusive source of superoxide production by endothelial NOS. Thus, calmodulin-mediated enzyme regulation affects production of nitric oxide and superoxide simultaneously and inseparably. The balance between the nitric oxide/superoxide reaction pathways may be shifted by addition of exogenous heme-specific agents, such as tetrahydrobiopterin. Our results have direct relevance for the pathophysiology of atherosclerosis.
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Affiliation(s)
- E Stroes
- Department of Nephrology and Vascular Medicine, F 03.226, University Hospital Utrecht, The Netherlands.
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Affiliation(s)
- R Wever
- Department of Nephrology and Hypertension, University Hospital Utrecht, The Netherlands
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Stroes E, de Bruin T, de Valk H, Erkelens W, Banga JD, van Rijn H, Koomans H, Rabelink T. NO activity in familial combined hyperlipidemia: potential role of cholesterol remnants. Cardiovasc Res 1997; 36:445-52. [PMID: 9534865 DOI: 10.1016/s0008-6363(97)00199-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Patients with familial combined hyperlipidemia (FCH) have an increased cardiovascular mortality despite only moderate elevations of LDL-cholesterol. Since endothelial NO release is intimately involved in the anti-atherosclerotic effects of the endothelium, we studied the effect of short-term lipid-lowering therapy on NO-mediated vasodilatation in patients with FCH. In view of only moderate LDL elevations, we evaluated whether alterations in other lipid fractions upon therapy correlated to changes in NO-mediated vasodilatation. METHODS NO activity was assessed by serotonin-induced, nitric oxide-mediated increase in forearm blood flow (FBF). Measurements were performed 2 weeks off and 4 weeks on lipid-lowering therapy in 12 FCH patients using forearm venous occlusion plethysmography. Control experiments were performed in 12 healthy subjects. RESULTS Serotonin-induced vasodilatation was impaired in FCH patients (FBF (unit ml/100 ml forearm tissue/min) from 3.0 (0.3) to 4.8 (0.4)) compared to controls (FBF from 2.9 (0.3) to 6.5 (0.6); p < 0.05 vs. FCH). FBF response to serotonin improved significantly upon lipid-lowering therapy (from 3.0 (0.3) to 5.7 (0.5); p < 0.05 treated vs. untreated). The level of improvement in endothelial function was significantly correlated to the absolute reduction of intermediate density lipoproteins upon lipid-lowering therapy (r = -0.64; p < 0.05), whereas it did not correlate to changes in VLDL- or LDL-cholesterol, nor to Lp(a). CONCLUSION Patients with familial combined hyperlipidemia have impaired NO-mediated vasodilatation, that responds rapidly to lipid lowering medication, and may be related to changes in intermediate density lipoproteins.
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Affiliation(s)
- E Stroes
- Department of Nephrology and Hypertension, University Hospital Utrecht, The Netherlands
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Stroes E, Kastelein J, Cosentino F, Erkelens W, Wever R, Koomans H, Lüscher T, Rabelink T. Tetrahydrobiopterin restores endothelial function in hypercholesterolemia. J Clin Invest 1997; 99:41-6. [PMID: 9011574 PMCID: PMC507765 DOI: 10.1172/jci119131] [Citation(s) in RCA: 407] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
In hypercholesterolemia, impaired nitric oxide activity has been associated with increased nitric oxide degradation by oxygen radicals. Deficiency of tetrahydrobiopterin, an essential cofactor of nitric oxide synthase, causes both impaired nitric oxide activity and increased oxygen radical formation. In this study we tested whether tetrahydrobiopterin deficiency contributes to the decreased nitric oxide activity observed in hypercholesterolemic patients. Therefore, L-mono-methyl-arginine to inhibit basal nitric oxide activity, serotonin to stimulate nitric oxide activity, and nitroprusside as endothelium-independent vasodilator were infused in the brachial artery of 13 patients with familial hypercholesterolemia and 13 matched controls. The infusions were repeated during coinfusion of L-arginine (200 microg/kg/min), tetrahydrobiopterin (500 microg/min), or the combination of both compounds. Forearm vasomotion was assessed using forearm venous occlusion plethysmography and expressed as ratio of blood flow between measurement and control arm (M/C ratio). Tetrahydrobiopterin infusion alone did not alter M/C ratio. Both the attenuated L-mono-methyl-arginine-induced vasoconstriction as well as the impaired serotonin-induced vasodilation were restored in patients during tetrahydrobiopterin infusion. Tetrahydrobiopterin had no effect in controls. In conclusion, this study demonstrates restoration of endothelial dysfunction by tetrahydrobiopterin suppletion in hypercholesterolemic patients.
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Affiliation(s)
- E Stroes
- Department of Nephrology, University Hospital Utrecht, The Netherlands
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