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Abelman RA, Fitzpatrick J, Byanova KL, Zawedde J, Sanyu I, Byanyima P, Musisi E, Hsieh J, Zhang M, Branchini J, Sessolo A, Hunt PW, Lalitha R, Davis JL, Crothers K, Worodria W, Huang L. Sex and HIV Differences in Preserved Ratio Impaired Spirometry (PRISm) Among Ugandans Postpneumonia. Open Forum Infect Dis 2024; 11:ofae033. [PMID: 38456193 PMCID: PMC10919919 DOI: 10.1093/ofid/ofae033] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 01/18/2024] [Indexed: 03/09/2024] Open
Abstract
Background Preserved ratio impaired spirometry (PRISm), defined as a normal ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (≥0.70) with low FEV1 (<80% predicted), has been associated with increased mortality in the general population. Female sex has been associated with increased odds of PRISm in people without HIV. People with HIV (PWH) are at increased risk for lung function abnormalities, but whether HIV modifies the effect of sex on PRISm development is largely unknown. Methods Adults with and without HIV underwent baseline followed by serial spirometry after completing therapy for pneumonia, predominantly tuberculosis (TB), in Kampala, Uganda. Using generalized estimating equations adjusted for age, body mass index, smoking, biomass fuel exposure, HIV, and TB status, we compared individuals with PRISm with those with normal spirometry. These models were stratified by HIV status. Results Of 339 baseline participants, 153 (45%) were women; 129 (38%) had HIV, of whom 53% were women. Overall, 105/339 participants (31%) had PRISm at baseline. HIV was associated with lower odds of PRISm (adjusted odds ratio [aOR], 0.38; 95% CI, 0.21-0.68; P = .001). Female sex trended toward increased odds of PRISm among all participants (aOR, 1.65; 95% CI, 0.99-2.75; P = .052). The association between female sex and PRISm tended to be stronger among PWH (aOR, 3.16; 95% CI, 1.14-8.76; P = .03) than among those without HIV (aOR, 1.34; 95% CI, 0.73-2.45; P = .34); this study was underpowered to detect an HIV-sex interaction of this magnitude (P = .30). Conclusions Among Ugandan adults who recovered from pneumonia, female sex was associated with increased odds and HIV with decreased odds of PRISm, suggesting independent sex and HIV effects on PRISm pathogenesis.
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Affiliation(s)
- Rebecca A Abelman
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jessica Fitzpatrick
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Katerina L Byanova
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | | | - Ingvar Sanyu
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | - Emmanuel Musisi
- Division of Infection and Global Health, School of Medicine, University of St. Andrews, St. Andrews, UK
| | - Jenny Hsieh
- Department of Anesthesia and Critical Care, University of California San Francisco, San Francisco, California, USA
| | - Michelle Zhang
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jake Branchini
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Abdul Sessolo
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Peter W Hunt
- Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Rejani Lalitha
- Division of Pulmonary Medicine, Department of Medicine, Makerere College of Health Sciences, Kampala, Uganda
| | - J Lucian Davis
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
- Pulmonary, Critical Care, and Sleep Medicine Section, Yale School of Medicine, New Haven, Connecticut, USA
| | - Kristina Crothers
- Division of Pulmonary, Critical Care and Sleep, Department of Medicine, Veterans Affairs (VA) Puget Sound Health Care System and University of Washington, Seattle, Washington, USA
| | - William Worodria
- Division of Pulmonary Medicine, Department of Medicine, Makerere College of Health Sciences, Kampala, Uganda
- Division of Pulmonary Medicine, Department of Medicine, Mulago Hospital and Complex, Kampala, Uganda
| | - Laurence Huang
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
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Byanova KL, Abelman R, North CM, Christenson SA, Huang L. COPD in People with HIV: Epidemiology, Pathogenesis, Management, and Prevention Strategies. Int J Chron Obstruct Pulmon Dis 2023; 18:2795-2817. [PMID: 38050482 PMCID: PMC10693779 DOI: 10.2147/copd.s388142] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/09/2023] [Indexed: 12/06/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by airflow limitation and persistent respiratory symptoms. People with HIV (PWH) are particularly vulnerable to COPD development; PWH have demonstrated both higher rates of COPD and an earlier and more rapid decline in lung function than their seronegative counterparts, even after accounting for differences in cigarette smoking. Factors contributing to this HIV-associated difference include chronic immune activation and inflammation, accelerated aging, a predilection for pulmonary infections, alterations in the lung microbiome, and the interplay between HIV and inhalational toxins. In this review, we discuss what is known about the epidemiology and pathobiology of COPD among PWH and outline screening, diagnostic, prevention, and treatment strategies.
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Affiliation(s)
- Katerina L Byanova
- Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Rebecca Abelman
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Crystal M North
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Stephanie A Christenson
- Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Laurence Huang
- Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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Byanova KL, Huang L. Response to: 'No long-term effect of past Pneumocystis jirovecii pneumonia on pulmonary function in people with HIV'. AIDS 2023; 37:2267-2268. [PMID: 37877285 DOI: 10.1097/qad.0000000000003691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Affiliation(s)
| | - Laurence Huang
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine
- Division of HIV, Infectious Diseases and Global Medicine, University of California San Francisco, San Francisco, California, USA
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Abelman RA, Fitzpatrick J, Zawedde J, Sanyu I, Byanyima P, Kaswabuli S, Musisi E, Hsieh J, Gardner K, Zhang M, Byanova KL, Sessolo A, Hunt PW, Lalitha R, Davis JL, Crothers K, Worodria W, Huang L. Sex modifies the risk of HIV-associated obstructive lung disease in Ugandans postpneumonia. AIDS 2023; 37:1683-1692. [PMID: 37352494 PMCID: PMC10527596 DOI: 10.1097/qad.0000000000003626] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
OBJECTIVES Spirometric abnormalities are frequent, and obstructive lung disease (OLD) is a common comorbidity among people with HIV (PWH). HIV increases the risk of many comorbidities to a greater degree in women than in men. Few studies have evaluated whether sex modifies the HIV-associated risk of OLD. DESIGN AND METHODS To evaluate the associations between sex and HIV with abnormal lung function, women and men with and without HIV underwent spirometric testing after completing therapy for pneumonia, including tuberculosis (TB), in Kampala, Uganda. OLD was defined as a postbronchodilator forced expiratory volume in the first second to forced vital capacity (FEV 1 /FVC) ratio less than 0.70. Associations between sex, HIV, and lung function were evaluated using multivariable regression models including sex-by-HIV interaction terms after adjusting for age, BMI, smoking status, and TB status. RESULTS Among 348 participants, 147 (42%) were women and 135 (39%) were HIV-positive. Sixteen (11%) women and 23 men (11%) had OLD. The HIV-sex interaction was significant for obstructive lung disease ( P = 0.04). In the adjusted stratified analysis, women with HIV had 3.44 (95% CI 1.11-12.0; P = 0.04) increased odds of having OLD compared with men with HIV. Women without HIV did not have increased odds of having OLD compared with men without HIV. CONCLUSION HIV appears to increase the risk of OLD to a greater degree in women than in men in an urban Ugandan setting. The mechanistic explanation for this interaction by sex remains unclear and warrants further study.
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Affiliation(s)
- Rebecca A Abelman
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jessica Fitzpatrick
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | | | - Ingvar Sanyu
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | | | - Emmanuel Musisi
- Division of Infection and Global Health, School of Medicine, University of St. Andrews, St. Andrews, United Kingdom
| | - Jenny Hsieh
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine
| | - Kendall Gardner
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Michelle Zhang
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | | | - Abdul Sessolo
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Peter W Hunt
- Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Rejani Lalitha
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - J Lucian Davis
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health
- Pulmonary, Critical Care, and Sleep Medicine Section, Yale School of Medicine, New Haven, Connecticut
| | - Kristina Crothers
- Division of Pulmonary, Critical Care and Sleep, Department of Medicine, Veterans Affairs (VA) Puget Sound Healthcare System and University of Washington, Seattle, Washington, USA
| | - William Worodria
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Division of Pulmonary Medicine, Department of Medicine, Mulago Hospital and Complex, Kampala, Uganda
| | - Laurence Huang
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine
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Byanova KL, Fitzpatrick J, Jan AK, McGing M, Hartman-Filson M, Farr CK, Zhang M, Gardner K, Branchini J, Kerruish R, Bhide S, Bates A, Hsieh J, Abelman R, Hunt PW, Wang RJ, Crothers KA, Huang L. Isolated abnormal diffusing capacity for carbon monoxide (iso↓DLco) is associated with increased respiratory symptom burden in people with HIV infection. PLoS One 2023; 18:e0288803. [PMID: 37463173 PMCID: PMC10353811 DOI: 10.1371/journal.pone.0288803] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVES An isolated reduction in the diffusing capacity for carbon monoxide (DLco; iso↓DLco) is one of the most common pulmonary function test (PFT) abnormalities in people living with HIV (PWH), but its clinical implications are incompletely understood. In this study, we explored whether iso↓DLco in PWH is associated with a greater respiratory symptom burden. STUDY DESIGN Cross-sectional analysis. METHODS We used ATS/ERS compliant PFTs from PWH with normal spirometry (post-bronchodilator FEV1/FVC ≥0.7; FEV1, FVC ≥80% predicted) from the I AM OLD cohort in San Francisco, CA and Seattle, WA, grouped by DLco categorized as normal (DLco ≥lower limit of normal, LLN), mild iso↓DLco (LLN >DLco >60% predicted), and moderate-severe iso↓DLco (DLco ≤60% predicted). We performed multivariable analyses to test for associations between DLco and validated symptom-severity and quality of life questionnaires, including the modified Medical Research Council dyspnea scale (mMRC), the COPD Assessment Test (CAT), and St. George's Respiratory Questionnaire (SGRQ), as well as between DLco and individual CAT symptoms. RESULTS Mild iso↓DLco was associated only with a significantly higher SGRQ score. Moderate-severe iso↓DLco was associated with significantly higher odds of mMRC ≥2 and significantly higher CAT and SGRQ scores. PWH with moderate-severe iso↓DLco had increased odds of breathlessness, decreased activity, lower confidence leaving home, and less energy. CONCLUSIONS Iso↓DLco is associated with worse respiratory symptom scores, and this association becomes stronger with worsening DLco, suggesting that impaired gas exchange alone has a significant negative impact on the quality of life in PWH. Additional studies are ongoing to understand the etiology of this finding and design appropriate interventions.
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Affiliation(s)
- Katerina L. Byanova
- Department of Medicine, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Jessica Fitzpatrick
- Department of Medicine, Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Amanda K. Jan
- Department of Medicine, Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Maggie McGing
- Department of Medicine, Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Marlena Hartman-Filson
- Department of Medicine, Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Carly K. Farr
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, United States of America
| | - Michelle Zhang
- Department of Medicine, Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Kendall Gardner
- Department of Medicine, Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Jake Branchini
- Department of Medicine, Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Robert Kerruish
- School of Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, United States of America
| | - Sharvari Bhide
- Department of Medicine, Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Aryana Bates
- Department of Medicine, Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Jenny Hsieh
- Department of Anesthesia and Perioperative Care, Division of Respiratory Care Services, Zuckerberg San Francisco General Hospital, San Francisco, California, United States of America
| | - Rebecca Abelman
- Department of Medicine, Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Peter W. Hunt
- Department of Medicine, Division of Experimental Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Richard J. Wang
- Department of Medicine, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Kristina A. Crothers
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, United States of America
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, Washington, United States of America
| | - Laurence Huang
- Department of Medicine, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California San Francisco, San Francisco, California, United States of America
- Department of Medicine, Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, California, United States of America
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Abstract
Introduction: Chronic obstructive pulmonary disease (COPD) is more prevalent in people with HIV (PWH) than in the general population and leads to an increased burden of morbidity and mortality in this population. The mechanisms behind COPD development and progression in PWH are not fully elucidated, and there are no PWH-specific guidelines for COPD management. Areas covered: The goal of this broad narrative review is to review the epidemiology of COPD in PWH globally, highlight proposed pathways contributing to increased COPD prevalence and progression in PWH, discuss structural and functional changes in the lungs in this population, assesses the excess mortality and comorbidities in PWH with COPD, and address management practices for this unique population. Expert opinion: Understanding how a chronic viral infection leads to COPD, independent of cigarette smoking, is of critical scientific importance. Further research should focus on the pathophysiology of the interaction between HIV and COPD, and determine the role of disease-modifying risk factors such as opportunistic pneumonia and air pollution, as well as generate data from randomized clinical trials on the safety and efficacy of specific therapies for this vulnerable patient population.
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Affiliation(s)
- Katerina L Byanova
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Ken M. Kunisaki
- Section of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Joshua Vasquez
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Laurence Huang
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- HIV, Infectious Diseases, and Global Medicine Division, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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Clarke WT, Satyam VR, Fudman DI, Zullow S, Goyal KG, Byanova KL, Huang C, Feuerstein JD. Antibiotic prophylaxis and infectious complications in patients on peritoneal dialysis undergoing lower gastrointestinal endoscopy. Gastroenterol Rep (Oxf) 2020; 8:407-409. [PMID: 33163197 PMCID: PMC7603873 DOI: 10.1093/gastro/goaa017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 12/12/2019] [Accepted: 01/08/2020] [Indexed: 12/20/2022] Open
Affiliation(s)
- William T Clarke
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Venkata R Satyam
- Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - David I Fudman
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Samantha Zullow
- Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Kashika G Goyal
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Katerina L Byanova
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Christopher Huang
- Section of Gastroenterology, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Joseph D Feuerstein
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Chen J, Peters A, Papke CL, Villamizar C, Ringuette LJ, Cao J, Wang S, Ma S, Gong L, Byanova KL, Xiong J, Zhu MX, Madonna R, Kee P, Geng YJ, Brasier AR, Davis EC, Prakash S, Kwartler CS, Milewicz DM. Loss of Smooth Muscle α-Actin Leads to NF-κB-Dependent Increased Sensitivity to Angiotensin II in Smooth Muscle Cells and Aortic Enlargement. Circ Res 2017; 120:1903-1915. [PMID: 28461455 DOI: 10.1161/circresaha.117.310563] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 04/24/2017] [Accepted: 05/01/2017] [Indexed: 11/16/2022]
Abstract
RATIONALE Mutations in ACTA2, encoding the smooth muscle isoform of α-actin, cause thoracic aortic aneurysms, acute aortic dissections, and occlusive vascular diseases. OBJECTIVE We sought to identify the mechanism by which loss of smooth muscle α-actin causes aortic disease. METHODS AND RESULTS Acta2-/- mice have an increased number of elastic lamellae in the ascending aorta and progressive aortic root dilation as assessed by echocardiography that can be attenuated by treatment with losartan, an angiotensin II (AngII) type 1 receptor blocker. AngII levels are not increased in Acta2-/- aortas or kidneys. Aortic tissue and explanted smooth muscle cells from Acta2-/- aortas show increased production of reactive oxygen species and increased basal nuclear factor κB signaling, leading to an increase in the expression of the AngII receptor type I a and activation of signaling at 100-fold lower levels of AngII in the mutant compared with wild-type cells. Furthermore, disruption of smooth muscle α-actin filaments in wild-type smooth muscle cells by various mechanisms activates nuclear factor κB signaling and increases expression of AngII receptor type I a. CONCLUSIONS These findings reveal that disruption of smooth muscle α-actin filaments in smooth muscle cells increases reactive oxygen species levels, activates nuclear factor κB signaling, and increases AngII receptor type I a expression, thus potentiating AngII signaling in vascular smooth muscle cells without an increase in the exogenous levels of AngII.
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Affiliation(s)
- Jiyuan Chen
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Andrew Peters
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Christina L Papke
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Carlos Villamizar
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Lea-Jeanne Ringuette
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Jiumei Cao
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Shanzhi Wang
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Shuangtao Ma
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Limin Gong
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Katerina L Byanova
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Jian Xiong
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Michael X Zhu
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Rosalinda Madonna
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Patrick Kee
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Yong-Jian Geng
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Allan R Brasier
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Elaine C Davis
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Siddharth Prakash
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Callie S Kwartler
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Dianna M Milewicz
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.).
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9
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Gardner TB, Spangler CC, Byanova KL, Ripple GH, Rockacy MJ, Levenick JM, Smith KD, Colacchio TA, Barth RJ, Zaki BI, Tsapakos MJ, Gordon SR. Cost-effectiveness and clinical efficacy of biliary stents in patients undergoing neoadjuvant therapy for pancreatic adenocarcinoma in a randomized controlled trial. Gastrointest Endosc 2016; 84:460-6. [PMID: 26972022 PMCID: PMC4988865 DOI: 10.1016/j.gie.2016.02.047] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 02/26/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS The optimal type of stent for the palliation of malignant biliary obstruction in patients with pancreatic adenocarcinoma undergoing neoadjuvant chemoradiotherapy with curative intent is unknown. We performed a prospective trial comparing 3 types of biliary stents-fully covered self-expandable metal (fcSEMS), uncovered self-expandable metal (uSEMS), and plastic-to determine which best optimized cost-effectiveness and important clinical outcomes. METHODS In this prospective randomized trial, consecutive patients with malignant biliary obstruction from newly diagnosed pancreatic adenocarcinoma who were to start neoadjuvant chemoradiotherapy were randomized to receive fcSEMSs, uSEMSs, or plastic stents during the index ERCP. The primary outcomes were time to stent occlusion, attempted surgical resection, or death after the initiation of neoadjuvant therapy, and the secondary outcomes were total patient costs associated with the stent, including the index ERCP cost, downstream hospitalization cost due to stent occlusion, and the cost associated with procedural adverse event. RESULTS Fifty-four patients were randomized and reached the primary end point: 16 in the fcSEMS group, 17 in the uSEMS group, and 21 in the plastic stent group. No baseline demographic or tumor characteristic differences were noted among the groups. The fcSEMSs had a longer time to stent occlusion compared with uSEMSs and plastic stents (220 vs 74 and 76 days, P < .01), although the groups had equivalent rates of stent occlusion, attempted surgical resection, and death. Although SEMS placement cost more during the index ERCP (uSEMS = $24,874 and fcSEMS = $22,729 vs plastic = $18,701; P < .01), they resulted in higher procedural AE costs per patient (uSEMS = $5522 and fcSEMS = $12,701 vs plastic = $0; P < .01). Conversely, plastic stents resulted in an $11,458 hospitalization cost per patient due to stent occlusion compared with $2301 for uSEMSs and $0 for fcSEMSs (P < .01). CONCLUSIONS In a prospective trial comparing fcSEMSs, uSEMSs, and plastic stents for malignant biliary obstruction in patients undergoing neoadjuvant therapy with curative intent for pancreatic adenocarcinoma, no stent type was superior in optimizing cost-effectiveness, although fcSEMSs resulted in fewer days of neoadjuvant treatment delay and a longer time to stent occlusion. (Clincial trial registration number: NCT01038713.).
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Affiliation(s)
- Timothy B. Gardner
- Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Chad C. Spangler
- Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Katerina L. Byanova
- Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Gregory H. Ripple
- Section of Hematology and Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Matthew J. Rockacy
- Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - John M. Levenick
- Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | | | | | - Richard J. Barth
- Section of General Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Bassem I. Zaki
- Division of Radiation Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | | | - Stuart R. Gordon
- Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
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10
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Chen J, Kwartler C, Papke CL, Peters A, Ringuette LJ, Cao J, Wang S, Villamizar C, Byanova KL, Madonna R, Kee P, Geng YJ, Brasier AR, Davis EC, Prakash S, Milewicz DM. Abstract 458: Loss of Smooth Muscle α-actin in Mice Results in Thoracic Aortic Aneurysms via Increased Reactive Oxygen Species, Increased Nox4,and Increased Angiotensin II type 1 Receptor-Mediated Signaling. Arterioscler Thromb Vasc Biol 2015. [DOI: 10.1161/atvb.35.suppl_1.458] [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: 11/16/2022]
Abstract
Objective:
ACTA2 mutations cause 10-14% of familial thoracic aortic aneurysms and dissections. Mice deficient in smooth muscle α-actin (Acta2-/-) develop root and ascending thoracic aortic enlargement associated with thickening of the aortic media and fragmentation and disarray of elastic fibers. We hypothesized that blocking AT1 activation would block the aortic pathology and prevent aortic enlargement in Acta2-/- mice.
Methods and Results:
Beginning at 4 weeks of age, Acta2-/- mice were treated with losartan or placebo (n≥10) for 6 months and echocardiograms were performed at baseline and every other month. The aortic root in Acta2-/- mice was found to undergo progressive dilatation. After 6 months of treatment, there was no difference in the diameter of the aortic root between wild-type (WT) mice and the losartan treated mice (p=0.44). Histologic analysis of Acta2-/- aortas demonstrated medial thickening and fragmentation of elastic fibers which was normalized by treatment with losartan. Gene expression of matrix metalloproteinase-2 and -9 (Mmp2, Mmp9), along with lumican and decorin, interleukin-6 (Il6) and phosphorylation of RelA (a subunit of nuclear factor κB, NF-κB) was increased in Acta2-/- aortas, and was corrected by treatment with losartan. NADPH oxidase 4 and AT1a mRNA was increased in Acta2-/- aortic smooth muscle cells (SMCs) and aortas. Increase of AT1a was blocked by lowering reactive oxygen species (ROS) with N-actetyl cysteine (NAC). Angiotensin II (AngII) dose response studies suggested Acta2-/- aortic SMCs had increased sensitivity to Ang II. Additionally, Acta2-/- SMCs had increased ROS compared to WT by flow cytometry (P<0.05). Increased ROS was also observed in aortic samples derived from Acta2-/- mice. Blocking ROS using NAC attenuated aneurysm formation by reducing the expression of Mmps and IL6 and reducing signaling through AT1 in Acta2-/- mice. Genetic deletion of AT1a attenuated ROS and expression of Mmps and IL6 levels in the Acta2-/-aortas but not to WT levels.
Conclusions:
Our results demonstrate that complete loss of α-SMA leads to aortic dilation and pathologic changes by increasing SMC ROS levels, thus increasing sensitivity to AngII, which results in NF-κB activation and increased expression of Mmps and IL6.
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Affiliation(s)
- Jiyuan Chen
- Dept of Internal Medicine, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Callie Kwartler
- Dept of Internal Medicine, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Christina L Papke
- Dept of Internal Medicine, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Andrew Peters
- Dept of Internal Medicine, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | | | - Jiumei Cao
- Dept of Internal Medicine, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Shanzhi Wang
- Dept of Internal Medicine, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Carlos Villamizar
- Dept of Internal Medicine, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Katerina L Byanova
- Dept of Internal Medicine, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Rosalinda Madonna
- Dept of Internal Medicine, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Patrick Kee
- Dept of Internal Medicine, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Yong-Jian Geng
- Dept of Internal Medicine, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Allan R Brasier
- Depts of Internal Medicine and Biochemistry and Molecular Biology, Univ of Texas Med Branch, Galveston, TX
| | - Elaine C Davis
- 3Dept of Anatomy and Physiology, Univ Montreal, Montreal, Canada
| | - Siddharth Prakash
- Dept of Internal Medicine, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Dianna M Milewicz
- Dept of Internal Medicine, The Univ of Texas Health Science Cntr at Houston, Houston, TX
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11
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Papke CL, Cao J, Kwartler CS, Villamizar C, Byanova KL, Lim SM, Sreenivasappa H, Fischer G, Pham J, Rees M, Wang M, Chaponnier C, Gabbiani G, Khakoo AY, Chandra J, Trache A, Zimmer W, Milewicz DM. Smooth muscle hyperplasia due to loss of smooth muscle α-actin is driven by activation of focal adhesion kinase, altered p53 localization and increased levels of platelet-derived growth factor receptor-β. Hum Mol Genet 2013; 22:3123-37. [PMID: 23591991 DOI: 10.1093/hmg/ddt167] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Mutations in ACTA2, encoding the smooth muscle cell (SMC)-specific isoform of α-actin (α-SMA), cause thoracic aortic aneurysms and dissections and occlusive vascular diseases, including early onset coronary artery disease and stroke. We have shown that occlusive arterial lesions in patients with heterozygous ACTA2 missense mutations show increased numbers of medial or neointimal SMCs. The contribution of SMC hyperplasia to these vascular diseases and the pathways responsible for linking disruption of α-SMA filaments to hyperplasia are unknown. Here, we show that the loss of Acta2 in mice recapitulates the SMC hyperplasia observed in ACTA2 mutant SMCs and determine the cellular pathways responsible for SMC hyperplasia. Acta2(-/-) mice showed increased neointimal formation following vascular injury in vivo, and SMCs explanted from these mice demonstrated increased proliferation and migration. Loss of α-SMA induced hyperplasia through focal adhesion (FA) rearrangement, FA kinase activation, re-localization of p53 from the nucleus to the cytoplasm and increased expression and ligand-independent activation of platelet-derived growth factor receptor beta (Pdgfr-β). Disruption of α-SMA in wild-type SMCs also induced similar cellular changes. Imatinib mesylate inhibited Pdgfr-β activation and Acta2(-/-) SMC proliferation in vitro and neointimal formation with vascular injury in vivo. Loss of α-SMA leads to SMC hyperplasia in vivo and in vitro through a mechanism involving FAK, p53 and Pdgfr-β, supporting the hypothesis that SMC hyperplasia contributes to occlusive lesions in patients with ACTA2 missense mutations.
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Affiliation(s)
- Christina L Papke
- Department of Internal Medicine, University of Texas Health Science Center at Houston, 6431 Fannin, MSB 6.100, Houston, TX 77030, USA
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12
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Temeles EJ, Rah YJ, Andicoechea J, Byanova KL, Giller GSJ, Stolk SB, Kress WJ. Pollinator-mediated selection in a specialized hummingbird-Heliconia system in the Eastern Caribbean. J Evol Biol 2012. [PMID: 23199234 DOI: 10.1111/jeb.12053] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Phenotypic matches between plants and their pollinators often are interpreted as examples of reciprocal selection and adaptation. For the two co-occurring plant species, Heliconia bihai and H. caribaea in the Eastern Caribbean, we evaluated for five populations over 2 years the strength and direction of natural selection on corolla length and number of bracts per inflorescence. These plant traits correspond closely to the bill lengths and body masses of their primary pollinators, female or male purple-throated carib hummingbirds (Eulampis jugularis). In H. bihai, directional selection for longer corollas was always significant with the exception of one population in 1 year, whereas selection on bract numbers was rare and found only in one population in 1 year. In contrast, significant directional selection for more bracts per inflorescence occurred in all three populations of the yellow morph and in two populations of the red morph of H. caribaea, whereas significant directional selection on corolla length occurred in only one population of the red morph and one population of the yellow morph. Selection for longer corollas in H. bihai may result from better mechanical fit, and hence pollination, by the long bills of female E. jugularis, their sole pollinator. In contrast, competition between males of E. jugularis for territories may drive selection for more bracts in H. caribaea. Competitive exclusion of female E. jugularis by territorial males also implicates pollinator competition as a possible ecological mechanism for trait diversification in these plants.
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Affiliation(s)
- E J Temeles
- Department of Biology, Amherst College, Amherst, MA 01002, USA.
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Kuang SQ, Kwartler CS, Byanova KL, Pham J, Gong L, Prakash SK, Huang J, Kamm KE, Stull JT, Sweeney HL, Milewicz DM. Rare, nonsynonymous variant in the smooth muscle-specific isoform of myosin heavy chain, MYH11, R247C, alters force generation in the aorta and phenotype of smooth muscle cells. Circ Res 2012; 110:1411-22. [PMID: 22511748 DOI: 10.1161/circresaha.111.261743] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [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: 01/04/2023]
Abstract
RATIONALE Mutations in myosin heavy chain (MYH11) cause autosomal dominant inheritance of thoracic aortic aneurysms and dissections. At the same time, rare, nonsynonymous variants in MYH11 that are predicted to disrupt protein function but do not cause inherited aortic disease are common in the general population and the vascular disease risk associated with these variants is unknown. OBJECTIVE To determine the consequences of the recurrent MYH11 rare variant, R247C, through functional studies in vitro and analysis of a knock-in mouse model with this specific variant, including assessment of aortic contraction, response to vascular injury, and phenotype of primary aortic smooth muscle cells (SMCs). METHODS AND RESULTS The steady state ATPase activity (actin-activated) and the rates of phosphate and ADP release were lower for the R247C mutant myosin than for the wild-type, as was the rate of actin filament sliding in an in vitro motility assay. Myh11(R247C/R247C) mice exhibited normal growth, reproduction, and aortic histology but decreased aortic contraction. In response to vascular injury, Myh11(R247C/R247C) mice showed significantly increased neointimal formation due to increased SMC proliferation when compared with the wild-type mice. Primary aortic SMCs explanted from the Myh11(R247C/R247C) mice were dedifferentiated compared with wild-type SMCs based on increased proliferation and reduced expression of SMC contractile proteins. The mutant SMCs also displayed altered focal adhesions and decreased Rho activation, associated with decreased nuclear localization of myocardin-related transcription factor-A. Exposure of the Myh11(R247C/R247C) SMCs to a Rho activator rescued the dedifferentiated phenotype of the SMCs. CONCLUSIONS These results indicate that a rare variant in MYH11, R247C, alters myosin contractile function and SMC phenotype, leading to increased proliferation in vitro and in response to vascular injury.
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Affiliation(s)
- Shao-Qing Kuang
- Department of Internal Medicine, The University of Texas Medical School at Houston, Houston, TX 77030, USA
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