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Katz MG, Eliyahu E, Ishikawa K. Gene delivery in a rodent lung transplant model. J Thorac Cardiovasc Surg 2024; 167:e142-e143. [PMID: 38363258 DOI: 10.1016/j.jtcvs.2024.01.016] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/17/2024]
Affiliation(s)
- Michael G Katz
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Efrat Eliyahu
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY; Icahn School for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY
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Mazurek R, Kariya T, Sakata T, Mavropoulos SA, Ravichandran AJ, Romeo FJ, Yamada KP, Ishikawa K. Negative Impact of Acute Reloading after Mechanical Left Ventricular Unloading. J Cardiovasc Transl Res 2024; 17:233-241. [PMID: 37022610 PMCID: PMC10556198 DOI: 10.1007/s12265-023-10371-z] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/08/2023] [Indexed: 04/07/2023]
Abstract
Mechanical LV unloading for acute myocardial infarction (MI) is a promising supportive therapy to reperfusion. However, no data is available on exit strategy. We evaluated hemodynamic and cellular effects of reloading after Impella-mediated LV unloading in Yorkshire pigs. First, we conducted an acute study in normal heart to observe effects of unloading and reloading independent of MI-induced ischemic effects. We then completed an MI study to investigate optimal exit strategy on one-week infarct size, no-reflow area, and LV function with different reloading speeds. Initial studies showed that acute reloading causes an immediate rise in end-diastolic wall stress followed by a significant increase in cardiomyocyte apoptosis. The MI study did not result in any statistically significant findings; however, numerically smaller average infarct size and no-reflow area in the gradual reloading group prompt further examination of reloading approach as an important clinically relevant consideration.
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Affiliation(s)
- Renata Mazurek
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1014, New York, NY, 10029, USA
| | - Taro Kariya
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1014, New York, NY, 10029, USA
| | - Tomoki Sakata
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1014, New York, NY, 10029, USA
| | - Spyros A Mavropoulos
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1014, New York, NY, 10029, USA
| | - Anjali J Ravichandran
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1014, New York, NY, 10029, USA
| | - Francisco J Romeo
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1014, New York, NY, 10029, USA
| | - Kelly P Yamada
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1014, New York, NY, 10029, USA
| | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1014, New York, NY, 10029, USA.
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Sakata T, Mavropoulos SA, Mazurek R, Romeo FJ, Ravichandran AJ, Marx JM, Kariya T, Ishikawa K. Reduction of left ventricular diastolic pressure as a key regulator of infarct coronary flow under mechanical left ventricular support. J Physiol 2024; 602:1669-1680. [PMID: 38457313 DOI: 10.1113/jp285586] [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] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/13/2024] [Indexed: 03/10/2024] Open
Abstract
Restoring ischaemic myocardial tissue perfusion is crucial for minimizing infarct size. Acute mechanical left ventricular (LV) support has been suggested to improve infarct tissue perfusion. However, its regulatory mechanism remains unclear. We investigated the physiological mechanisms in six Yorkshire pigs, which were subjected to 90-min balloon occlusion of the left anterior descending artery. During the acute reperfusion phase, LV support using an Impella heart pump was initiated. LV pressure, coronary flow and pressure of the infarct artery were simultaneously recorded to evaluate the impact of LV support on coronary physiology. Coronary wave intensity was calculated to understand the forces regulating coronary flow. Significant increases in coronary flow velocity and its area under the curve were found after mechanical LV support. Among the coronary flow-regulating factors, coronary pressure was increased mainly during the late diastolic phase with less pulsatility. Meanwhile, LV pressure was reduced throughout diastole resulting in significant and consistent elevation of coronary driving pressure. Interestingly, the duration of diastole was prolonged with LV support. In the wave intensity analysis, the duration between backward suction and pushing waves was extended, indicating that earlier myocardial relaxation and delayed contraction contributed to the extension of diastole. In conclusion, mechanical LV support increases infarct coronary flow by extending diastole and augmenting coronary driving pressure. These changes were mainly driven by reduced LV diastolic pressure, indicating that the key regulator of coronary flow under mechanical LV support is downstream of the coronary artery, rather than upstream. Our study highlights the importance of LV diastolic pressure in infarct coronary flow regulation. KEY POINTS: Restoring ischaemic myocardial tissue perfusion is crucial for minimizing infarct size. Although mechanical left ventricular (LV) support has been suggested to improve infarct coronary flow, its specific mechanism remains to be clarified. LV support reduced LV pressure, and elevated coronary pressure during the late diastolic phase, resulting in high coronary driving pressure. This study demonstrated for the first time that mechanical LV support extends diastolic phase, leading to increased infarct coronary flow. Future studies should evaluate the correlation between improved infarct coronary flow and resulting infarct size.
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Affiliation(s)
- Tomoki Sakata
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Cardiac Surgery, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Spyros A Mavropoulos
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Renata Mazurek
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Francisco J Romeo
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anjali J Ravichandran
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonas M Marx
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Taro Kariya
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Deguchi N, Ishikawa K, Tokioka S, Kobayashi D, Mori N. Relationship between blood culture time to positivity, mortality rate, and severity of bacteremia. Infect Dis Now 2024; 54:104843. [PMID: 38043910 DOI: 10.1016/j.idnow.2023.104843] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVES We investigated the association between patient severity or mortality and time to positivity in bacteremia caused by various pathogens. PATIENTS AND METHODS This single-center retrospective study included patients with positive blood culture results. RESULTS Longer time to positivity was associated with 30-day mortality for Staphylococcus aureus (221 cases, time to positivity: 17.4 h in the 30-day mortality group vs. 14.1 h in the survival group). Age, chronic kidney disease, cerebrovascular disease, hypertensive drug use, consciousness disorder, and minimal systolic blood pressure were significant predictors of 30-day mortality. For S. aureus, mortality within 30 days was significantly higher when time to positivity was > 24 h (p = 0.04). The time to positivity of Streptococcus pneumoniae, α, β-hemolytic Streptococcus, Enterococcus sp., Enterobacteriaceae, glucose-nonfermenting Gram-negative rods, Candida sp., and anaerobe was not significantly associated with 30-day mortality. CONCLUSIONS Among various pathogens, time to positivity > 24 h was associated with 30-day mortality for S. aureus.
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Affiliation(s)
- N Deguchi
- Department of Infectious Diseases, St. Luke's International Hospital, Tokyo, Japan
| | - K Ishikawa
- Department of Infectious Diseases, St. Luke's International Hospital, Tokyo, Japan.
| | - S Tokioka
- Department of Cardiovascular Medicine, Sendai Medical Center, Sendai, Japan
| | - D Kobayashi
- Department of Primary Care and General Medicine Tokyo Medical University Ibaraki Medical Center, Japan
| | - N Mori
- Department of Infectious Diseases, St. Luke's International Hospital, Tokyo, Japan
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Emelyanenko AV, Rudyak VY, Shvetsov SA, Araoka F, Nishikawa H, Ishikawa K. Transformation of polar nematic phases in the presence of an electric field. Phys Rev E 2024; 109:014701. [PMID: 38366416 DOI: 10.1103/physreve.109.014701] [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] [Received: 07/30/2023] [Accepted: 12/07/2023] [Indexed: 02/18/2024]
Abstract
Only a few years have passed since the discovery of polar nematics, and now they are becoming the most actively studied liquid-crystal materials. Despite numerous breakthrough findings made recently, a theoretical systematization is still lacking. In the present paper, we take a step toward systematization. The powerful technique of molecular-statistical physics has been applied to an assembly of polar molecules influenced by electric field. Three polar nematic phases were found to be stable at various conditions: the double-splay ferroelectric nematic N_{F}^{2D} (observed in the lower-temperature range in the absence of or at low electric field), the double-splay antiferroelectric nematic N_{AF} (observed at intermediate temperature in the absence of or at low electric field), and the single-splay ferroelectric nematic N_{F}^{1D} (observed at moderate electric field at any temperature below transition into paraelectric nematic N and in the higher-temperature range (also below N) at low electric field or without it. A paradoxical transition from N_{F}^{1D} to N induced by application of higher electric field has been found and explained. A transformation of the structure of polar nematic phases at the application of electric field has also been investigated by Monte Carlo simulations and experimentally by observation of polarizing optical microscope images. In particular, it has been realized that, at planar anchoring, N_{AF} in the presence of a moderate out-of-plane electric field exhibits twofold splay modulation: antiferroelectric in the plane of the substrate and ferroelectric in the plane normal to the substrate. Several additional subtransitions related to fitting the confined geometry of the cell by the structure of polar phases were detected.
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Affiliation(s)
| | - V Yu Rudyak
- Lomonosov Moscow State University, Moscow 119991, Russia
| | - S A Shvetsov
- Lomonosov Moscow State University, Moscow 119991, Russia
| | - F Araoka
- RIKEN Center for Emergent Matter Science (CEMS), 2-1 Hirosawa Wako, Saitama 351-0198, Japan
| | - H Nishikawa
- RIKEN Center for Emergent Matter Science (CEMS), 2-1 Hirosawa Wako, Saitama 351-0198, Japan
| | - K Ishikawa
- Tokyo Institute of Technology, 2-12-1 Ookayama, Meguro-ku, Tokyo 152-8550, Japan
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Mazurek R, Bikou O, Ishikawa K. Swine Model of Myocardial Infarction Induced by Ischemia-Reperfusion and Embolization. Methods Mol Biol 2024; 2803:189-203. [PMID: 38676894 DOI: 10.1007/978-1-0716-3846-0_14] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
Acute myocardial infarction continues to account for a growing burden of heart failure worldwide. Despite existing therapies, new approaches for reducing the extent of damage and better managing heart failure progression are urgently needed. Preclinical large animal models are a critical step in the translation of scientific discoveries toward clinical trials and therapeutic application. In this chapter, we detail methods to induce swine models of myocardial infarction through catheter-mediated approaches involving either temporary (ischemia-reperfusion) or permanent (thrombus injection or embolic coil) occlusions. These techniques are relatively low in invasiveness, while infarct size with corresponding cardiac dysfunction can be controlled by adjusting the location of coronary occlusion. We also describe methods for cardiac angiography and echocardiography in pigs. This is the second edition of a previously published chapter with modifications.
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Affiliation(s)
- Renata Mazurek
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Olympia Bikou
- Department of Medicine I, LMU University Hospital, LMU Munich, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich, Germany
| | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Leonard K, Mavropoulos SA, Mazurek R, Ishikawa K. Swine Model of Coronary Artery Dissection. Methods Mol Biol 2024; 2803:219-226. [PMID: 38676896 DOI: 10.1007/978-1-0716-3846-0_16] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
Coronary artery dissection (CAD) is the intimal tearing of the coronary arterial wall and can be iatrogenic, spontaneous, or traumatic in origin. CAD is a rare but challenging condition that can cause significant hemodynamic compromise. Management strategies for CAD, such as the use of mechanical circulatory support devices, are available in the clinical setting. However, the incidence, etiology, and optimal management of CAD are not well-defined, emphasizing the need for adequate animal models in preclinical studies. Large animal models provide the human-like conditions necessary for testing and development of potential treatment strategies. In this chapter, we describe a method for the creation of a CAD swine model.
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Affiliation(s)
- Kyra Leonard
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Spyros A Mavropoulos
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Renata Mazurek
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Sakata T, Kohno H, Inui T, Ikeuchi H, Shiko Y, Kawasaki Y, Suzuki S, Tanaka S, Obana M, Ishikawa K, Fujio Y, Matsumiya G. Cardioprotective effect of Interleukin-11 against warm ischemia-reperfusion injury in a rat heart donor model. Eur J Pharmacol 2023; 961:176145. [PMID: 37923160 DOI: 10.1016/j.ejphar.2023.176145] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/08/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023]
Abstract
Shortage of donor organs for heart transplantation is a worldwide problem. Donation after circulatory death (DCD) has been proposed to expand the donor pool. However, in contrast to the donation after brain death that undergoes immediate cold preservation, warm ischemia and subsequent reperfusion injury are inevitable in DCD. It has been reported that interleukin-11 (IL-11) mitigates ischemia-reperfusion injury in rodent models of myocardial infarction and donation after brain death heart transplantation. We hypothesized that IL-11 also offers benefit to warm ischemia in an experimental model of cardiac transplantation that resembles DCD. The hearts of naïve male Sprague Dawley rats (n = 15/group) were procured, subjected to 25-min warm ischemia, and reperfused for 60 min using Langendorff apparatus. IL-11 or saline was administered intravenously before the procurement, added to maintenance buffer, and infused via perfusion during reperfusion. IL-11 group exhibited significantly better cardiac function post-reperfusion. Severely damaged mitochondria was found in the electron microscopic analysis of control hearts whereas the mitochondrial structure was better preserved in the IL-11 treated hearts. Immunoblot analysis using neonatal rat cardiomyocytes revealed increased signal transducer and activator of transcription 3 (STAT3) phosphorylation at Ser727 after IL-11 treatment, suggesting its role in mitochondrial protection. Consistent with expected activation of mitochondrial respiration by mitochondrial STAT3, immunohistochemical staining demonstrated a higher mitochondrial cytochrome c oxidase subunit 2 expression. In summary, IL-11 protects the heart from warm ischemia reperfusion injury by alleviating mitochondrial injury and could be a viable therapeutic option for DCD heart transplantation.
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Affiliation(s)
- Tomoki Sakata
- Department of Cardiovascular Surgery, Chiba University Hospital, Chiba, Japan; Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, USA.
| | - Hiroki Kohno
- Department of Cardiovascular Surgery, Chiba University Hospital, Chiba, Japan
| | - Tomohiko Inui
- Department of Cardiovascular Surgery, Chiba University Hospital, Chiba, Japan
| | - Hiroki Ikeuchi
- Department of Cardiovascular Surgery, Chiba University Hospital, Chiba, Japan
| | - Yuki Shiko
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yohei Kawasaki
- Faculty of Nursing, Japanese Red Cross College of Nursing, Tokyo, Japan
| | - Shota Suzuki
- Laboratory of Clinical Science and Biomedicine, Osaka University Graduate School of Pharmaceutical Sciences, Osaka, Japan
| | - Shota Tanaka
- Laboratory of Clinical Science and Biomedicine, Osaka University Graduate School of Pharmaceutical Sciences, Osaka, Japan
| | - Masanori Obana
- Laboratory of Clinical Science and Biomedicine, Osaka University Graduate School of Pharmaceutical Sciences, Osaka, Japan
| | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Yasushi Fujio
- Laboratory of Clinical Science and Biomedicine, Osaka University Graduate School of Pharmaceutical Sciences, Osaka, Japan
| | - Goro Matsumiya
- Department of Cardiovascular Surgery, Chiba University Hospital, Chiba, Japan
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Ota E, Hiyoshi Y, Matsuura N, Ishikawa K, Fujinami F, Mukai T, Yamaguchi T, Nagasaki T, Akiyoshi T, Fukunaga Y. Standardization of preoperative stoma site marking and its utility for preventing stoma leakage: a retrospective study of 519 patients who underwent laparoscopic/robotic rectal cancer surgery. Tech Coloproctol 2023; 27:1387-1392. [PMID: 37358669 DOI: 10.1007/s10151-023-02839-6] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 06/17/2023] [Indexed: 06/27/2023]
Abstract
PURPOSE Stoma site marking is an important preoperative intervention for preventing various stoma-associated complications. In our institution, standardized stoma site marking is routinely performed before rectal cancer surgery with stoma creation, and various stoma-associated factors are recorded in the ostomy-record template. The present study investigated risk factors for stoma leakage. METHODS Our stoma site marking is standardized so that it can be performed by non-stoma specialists. To identify risk factors of stoma leakage at 3 months after surgery, various preoperative factors associated with stoma site marking in our ostomy-record template were retrospectively analyzed in 519 patients who underwent rectal cancer surgery with stoma creation from 2015 to 2020. RESULTS Stoma leakage was seen in 35 of the 519 patients (6.7%). The distance between the stoma site marking and the umbilicus was less than 60 mm in 27 of the 35 patients (77%) who experienced stoma leakage, so a distance of less than 60 mm was identified as an independent risk factor for stoma leakage. Aside from preoperative factors, stoma leakage was also caused by postoperative skin wrinkles or surgical scars near the stoma site in 8 of 35 patients (23%). CONCLUSION Preoperative standardized stoma site marking is necessary to achieve reliable marking that is easy to perform. To reduce the risk of stoma leakage, a distance of 60 mm or more between the stoma site marking and the umbilicus is ideal, and surgeons need to contrive ways to keep surgical scars away from the stoma site.
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Affiliation(s)
- E Ota
- Gastroenterological Center, Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Y Hiyoshi
- Gastroenterological Center, Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - N Matsuura
- Gastroenterological Center, Department of Wound, Ostomy and Continence (WOC) Nursing, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - K Ishikawa
- Gastroenterological Center, Department of Wound, Ostomy and Continence (WOC) Nursing, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - F Fujinami
- Gastroenterological Center, Department of Wound, Ostomy and Continence (WOC) Nursing, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - T Mukai
- Gastroenterological Center, Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - T Yamaguchi
- Gastroenterological Center, Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - T Nagasaki
- Gastroenterological Center, Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - T Akiyoshi
- Gastroenterological Center, Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Y Fukunaga
- Gastroenterological Center, Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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Uehara T, Nishimura Y, Ishikawa K, Inada M, Matsumoto K, Doi H, Monzen H. Online Adaptive Radiotherapy for Pharyngeal Cancer: Dose-Volume Histogram Analysis between Adapted and Scheduled Plan. Int J Radiat Oncol Biol Phys 2023; 117:e729. [PMID: 37786121 DOI: 10.1016/j.ijrobp.2023.06.2247] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The present study aimed to evaluate whether online adapted plan with artificial intelligence (AI) driven work flow could be used in clinical settings with variable changes of the targets and organs at risk (OARs) for pharyngeal cancer. MATERIALS/METHODS Ten patients with pharyngeal cancer who underwent chemoradiotherapy at our institution between January and July 2020 were included for the analysis. All patients had been previously aligned daily with cone-beam computed tomography (CBCT) and treated by O-ring Linac. A simulated treatment was performed on the treatment emulator. Weekly fractions, once in every 4-5 fractions, were simulated in the treatment emulator for each patient using their previous on-treatment CBCTs. The dataset was divided into three groups according to the treatment period (1st-2nd week, 20 CBCTs), middle (3rd-4th week, 20 CBCTs), and late (5th-7th week, 30 CBCTs) period. In the present study, all of reference plan generation in treatment emulator were created on the initial plans of two-step method using 12 equidistant field IMRT. The prescribed dose was 70 Gy in 35 fractions and normalized to the dose of 68.6 Gy (98% dose) to 95% of the planning target volume (PTV). The adaptation process on treatment emulator includes auto-segmentation of daily anatomy, calculation of the dose in scheduled plans using the same monitor units and optimization and calculation of the dose in adapted plan. Dose-volume histogram (DVH) parameters between adapted and scheduled plans in terms of PTV (D98%, D95%, D50% and D2%), spinal cord (Dmax and D1cc), brain stem (Dmax), ipsilateral and contralateral parotid glands (Dmedian and Dmean) were evaluated in each period. RESULTS D98% of PTV of adapted plan was significantly higher than that of scheduled plan in early and middle period (p = 0.02 and <0.01, respectively). D95% of PTV of adapted plan was significantly higher than that of scheduled plan in all periods (p<0.01). D2% of PTV of adapted plan was significantly lower than that of scheduled plan in all periods (p = 0.04, 0.04 and 0.02 in each period, respectively). There was not significant difference in D50% of PTV between adapted and scheduled plan in all periods. In terms of OARs, Dmax of spinal cord of adapted plan was significantly lower than that of scheduled plan in all periods (p<0.01). Similarly, D1cc of spinal cord of adapted plan was lower than that of scheduled plan. Dmean of ipsilateral and contralateral parotid glands of adapted plan were lower than those of scheduled plan in the late period (p<0.01 and 0.03, respectively). CONCLUSION The present study revealed that adapted plan with AI driven work flow could create dosimetrically better plans for pharyngeal cancer compared to scheduled plan. It was suggested that online adaptive radiotherapy could be necessary to maintain PTV coverage while reducing the dose to OARs in all periods for pharyngeal cancer.
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Affiliation(s)
- T Uehara
- Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Y Nishimura
- Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - K Ishikawa
- Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - M Inada
- Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - K Matsumoto
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
| | - H Doi
- Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - H Monzen
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
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Uchiyama S, Sakata T, Tharakan S, Ishikawa K. Body temperature as a predictor of mortality in COVID-19. Sci Rep 2023; 13:13354. [PMID: 37587219 PMCID: PMC10432378 DOI: 10.1038/s41598-023-40414-z] [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] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 08/09/2023] [Indexed: 08/18/2023] Open
Abstract
It remains uncertain if body temperature (BT) is a useful prognostic indicator in coronavirus disease 2019 (COVID-19). We investigated the relationship between BT and mortality in COVID-19 patients. We used a de-identified database that prospectively collected information from patients screened for COVID-19 at the Mount Sinai facilities from February 28, 2020 to July 28, 2021. All patients diagnosed with COVID-19 that had BT data were included. BT at initial presentation, maximum BT during hospitalization, comorbidity, and vaccination status data were extracted. Mortality rate was assessed as a primary outcome. Among 24,293 cases, patients with initial BT below 36 °C had higher mortality than those with BT of 36-37 °C (p < 0.001, odds ratio 2.82). Initial BT > 38 °C was associated with high mortality with an incremental trend at higher BT. In 10,503 in-patient cases, a positive association was observed between mortality and maximum BT except in patients with BT < 36 °C. Multiple logistic regression analyses including the comorbidities revealed that maximum BT was an independent predictor of mortality. While vaccination did not change the distribution of maximum BT, mortality was decreased in vaccinated patients. Our retrospective cohort study suggests that high maximum BT is an independent predictor of higher mortality in COVID-19 patients.
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Affiliation(s)
- Shuhei Uchiyama
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1014, New York, NY, USA
- Department of Medicine, Mount Sinai Beth Israel, New York, NY, USA
| | - Tomoki Sakata
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1014, New York, NY, USA
| | - Serena Tharakan
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1014, New York, NY, USA
| | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1014, New York, NY, USA.
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12
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Ravichandran AJ, Romeo FJ, Mazurek R, Ishikawa K. Barriers in Heart Failure Gene Therapy and Approaches to Overcome Them. Heart Lung Circ 2023; 32:780-789. [PMID: 37045653 PMCID: PMC10440286 DOI: 10.1016/j.hlc.2023.02.011] [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] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 01/30/2023] [Accepted: 02/13/2023] [Indexed: 04/14/2023]
Abstract
With the growing prevalence and incidence of heart failure worldwide, investigation and development of new therapies to address disease burden are of great urgency. Gene therapy is one promising approach for the management of heart failure, but several barriers currently exclude safe and efficient gene delivery to the human heart. These barriers include the anatomical and biological difficulty of specifically targeting cardiomyocytes, the vascular endothelium, and immunogenicity against administered vectors and the transgene. We review approaches taken to overcome these barriers with a focus on vector modification, evasion of immune responses, and heart-targeted delivery techniques. While various modifications proposed to date show promise in managing some barriers, continued investigation into improvements to existing therapies is required to address transduction efficiency, duration of transgene expression, and immune response.
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Affiliation(s)
- Anjali J Ravichandran
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Francisco J Romeo
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. https://twitter.com/FJRomeoMD
| | - Renata Mazurek
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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13
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Romeo FJ, Mavropoulos SA, Ishikawa K. Correction: Progress in Clinical Gene Therapy for Cardiac Disorders. Mol Diagn Ther 2023:10.1007/s40291-023-00657-y. [PMID: 37300634 DOI: 10.1007/s40291-023-00657-y] [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] [Accepted: 04/13/2023] [Indexed: 06/12/2023]
Affiliation(s)
- Francisco J Romeo
- Icahn School of Medicine at Mount Sinai, Cardiovascular Research Institute, 1 Gustave L. Levy Place, Box 1014, New York, NY, 10029, USA
| | - Spyros A Mavropoulos
- Icahn School of Medicine at Mount Sinai, Cardiovascular Research Institute, 1 Gustave L. Levy Place, Box 1014, New York, NY, 10029, USA
| | - Kiyotake Ishikawa
- Icahn School of Medicine at Mount Sinai, Cardiovascular Research Institute, 1 Gustave L. Levy Place, Box 1014, New York, NY, 10029, USA.
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14
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Ohsaka H, Muramatsu KI, Fujita W, Jitsuiki K, Ishikawa K, Yanagawa Y. Evacuation from a military base via physician-staffed helicopters. BMJ Mil Health 2023:military-2023-002443. [PMID: 37217207 DOI: 10.1136/military-2023-002443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 05/08/2023] [Indexed: 05/24/2023]
Affiliation(s)
- Hiromichi Ohsaka
- Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan
| | - K-I Muramatsu
- Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan
| | - W Fujita
- Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan
| | - K Jitsuiki
- Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan
| | - K Ishikawa
- Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan
| | - Y Yanagawa
- Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan
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15
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Santos-Gallego CG, Requena-Ibáñez JA, Picatoste B, Fardman B, Ishikawa K, Mazurek R, Pieper M, Sartori S, Rodriguez-Capitán J, Fuster V, Badimon JJ. Cardioprotective Effect of Empagliflozin and Circulating Ketone Bodies During Acute Myocardial Infarction. Circ Cardiovasc Imaging 2023; 16:e015298. [PMID: 37042253 DOI: 10.1161/circimaging.123.015298] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/17/2023] [Indexed: 04/13/2023]
Abstract
BACKGROUND SGLT2i (sodium-glucose cotransporter-2 inhibitors) improve clinical outcomes in patients with heart failure, but the mechanisms of action are not completely understood. SGLT2i increases circulating levels of ketone bodies, which has been demonstrated to enhance myocardial energetics and induce reverse ventricular remodeling. However, the role of SGLT2i or ketone bodies on myocardial ischemia reperfusion injury remains in the dark. The objective of this study is to investigate the cardioprotective potential of empagliflozin and ketone bodies during acute myocardial infarction (MI). METHODS We used a nondiabetic porcine model of ischemia reperfusion using a percutaneous occlusion of proximal left anterior descending artery for 45 minutes. Animals received 1-week pretreatment with either empagliflozin or placebo prior to MI induction. Additionally, a third group received intravenous infusion of the ketone body BOHB (beta-hydroxybutyrate) during the MI induction. Acute effects of the treatments were assessed 4-hour post-MI by cardiac magnetic resonance and histology (thioflavin for area at risk, triphenyltetrazolium chloride staining for MI size). All animals were euthanized immediately postcardiac magnetic resonance, and heart samples were collected. RESULTS The area at risk was similar in all groups. Empagliflozin treatment increased BOHB levels. Empagliflozin-treated animals showed significantly higher myocardial salvage, smaller MI size (both by cardiac magnetic resonance and histology), less microvascular obstruction, and improved cardiac function (left ventricle ejection fraction and strain). Furthermore, empagliflozin-treated animals demonstrated reduced biomarkers of cardiomyocyte apoptosis and oxidative stress compared with placebo. The BOHB group showed similar results to the empagliflozin group. CONCLUSIONS One-week pretreatment with empagliflozin ameliorates ischemia reperfusion injury, reduces MI size and microvascular obstruction, increases myocardial salvage, preserves left ventricle systolic function, and lowers apoptosis and oxidative stress. Periprocedural intravenous infusion of BOHB during myocardial ischemia also induces cardioprotection, suggesting a role for BOHB availability as an additional mechanism within the wide spectrum of actions of SGLT2i.
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Affiliation(s)
- Carlos G Santos-Gallego
- Atherothrombosis Research Unit (C.G.S.-G., J.A.R.-I., B.F., J.J.B.), Icahn School of Medicine at Mount Sinai, New York
- Mount Sinai Heart (C.G.S.-G., J.A.R.-I., B.F., K.I., R.M., S.S., V.F., J.J.B.), Icahn School of Medicine at Mount Sinai, New York
| | - Juan Antonio Requena-Ibáñez
- Atherothrombosis Research Unit (C.G.S.-G., J.A.R.-I., B.F., J.J.B.), Icahn School of Medicine at Mount Sinai, New York
- Mount Sinai Heart (C.G.S.-G., J.A.R.-I., B.F., K.I., R.M., S.S., V.F., J.J.B.), Icahn School of Medicine at Mount Sinai, New York
| | - Belen Picatoste
- Biochemistry Department, Weill Cornell Medical College, New York (B.P.)
| | - Brian Fardman
- Atherothrombosis Research Unit (C.G.S.-G., J.A.R.-I., B.F., J.J.B.), Icahn School of Medicine at Mount Sinai, New York
- Mount Sinai Heart (C.G.S.-G., J.A.R.-I., B.F., K.I., R.M., S.S., V.F., J.J.B.), Icahn School of Medicine at Mount Sinai, New York
| | - Kiyotake Ishikawa
- Mount Sinai Heart (C.G.S.-G., J.A.R.-I., B.F., K.I., R.M., S.S., V.F., J.J.B.), Icahn School of Medicine at Mount Sinai, New York
| | - Renata Mazurek
- Mount Sinai Heart (C.G.S.-G., J.A.R.-I., B.F., K.I., R.M., S.S., V.F., J.J.B.), Icahn School of Medicine at Mount Sinai, New York
| | - Michael Pieper
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany (M.P.)
| | - Samantha Sartori
- Mount Sinai Heart (C.G.S.-G., J.A.R.-I., B.F., K.I., R.M., S.S., V.F., J.J.B.), Icahn School of Medicine at Mount Sinai, New York
| | - Jorge Rodriguez-Capitán
- Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), Cardiology Department, Hospital Universitario Virgen de la Victoria, Spain (J.R.-C.)
- IBIMA-Plataforma BIONAND, Universidad de Málaga, Spain (J.R.-C.)
| | - Valentin Fuster
- Mount Sinai Heart (C.G.S.-G., J.A.R.-I., B.F., K.I., R.M., S.S., V.F., J.J.B.), Icahn School of Medicine at Mount Sinai, New York
| | - Juan J Badimon
- Atherothrombosis Research Unit (C.G.S.-G., J.A.R.-I., B.F., J.J.B.), Icahn School of Medicine at Mount Sinai, New York
- Mount Sinai Heart (C.G.S.-G., J.A.R.-I., B.F., K.I., R.M., S.S., V.F., J.J.B.), Icahn School of Medicine at Mount Sinai, New York
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16
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Abstract
Despite significant advances in novel treatments and approaches, cardiovascular disease remains the leading cause of death globally. Gene therapy is a promising option for many diseases, including cardiovascular diseases. In the last 30 years, gene therapy has slowly proceeded towards clinical translation and recently reached US Food and Drug Administration approval for several diseases such as Leber congenital amaurosis and spinal muscular atrophy, among others. Previous attempts at developing gene therapies for cardiovascular diseases have yielded promising results in preclinical studies and early-phase clinical trials. However, larger trials failed to demonstrate consistent benefits in patients with ischemic heart disease and heart failure. In this review, we summarize the history and current status of clinical cardiac gene therapy. Starting with angiogenic gene therapy, we also cover more recent gene therapy trials for heart failure and cardiomyopathies. New programs are actively vying to be the first to get Food and Drug Administration approval for a cardiac gene therapy product by taking advantage of novel techniques.
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Affiliation(s)
- Francisco J Romeo
- Icahn School of Medicine at Mount Sinai, Cardiovascular Research Institute, 1 Gustave L. Levy Place, Box 1014, New York, NY, 10029, USA
| | - Spyros A Mavropoulos
- Icahn School of Medicine at Mount Sinai, Cardiovascular Research Institute, 1 Gustave L. Levy Place, Box 1014, New York, NY, 10029, USA
| | - Kiyotake Ishikawa
- Icahn School of Medicine at Mount Sinai, Cardiovascular Research Institute, 1 Gustave L. Levy Place, Box 1014, New York, NY, 10029, USA.
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17
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Gorski PA, Lee A, Lee P, Oh JG, Vangheluwe P, Ishikawa K, Hajjar R, Kho C. Identification and Characterization of p300-Mediated Lysine Residues in Cardiac SERCA2a. Int J Mol Sci 2023; 24:ijms24043502. [PMID: 36834924 PMCID: PMC9959367 DOI: 10.3390/ijms24043502] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/07/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
Impaired calcium uptake resulting from reduced expression and activity of the cardiac sarco-endoplasmic reticulum Ca2+ ATPase (SERCA2a) is a hallmark of heart failure (HF). Recently, new mechanisms of SERCA2a regulation, including post-translational modifications (PTMs), have emerged. Our latest analysis of SERCA2a PTMs has identified lysine acetylation as another PTM which might play a significant role in regulating SERCA2a activity. SERCA2a is acetylated, and that acetylation is more prominent in failing human hearts. In this study, we confirmed that p300 interacts with and acetylates SERCA2a in cardiac tissues. Several lysine residues in SERCA2a modulated by p300 were identified using in vitro acetylation assay. Analysis of in vitro acetylated SERCA2a revealed several lysine residues in SERCA2a susceptible to acetylation by p300. Among them, SERCA2a Lys514 (K514) was confirmed to be essential for SERCA2a activity and stability using an acetylated mimicking mutant. Finally, the reintroduction of an acetyl-mimicking mutant of SERCA2a (K514Q) into SERCA2 knockout cardiomyocytes resulted in deteriorated cardiomyocyte function. Taken together, our data demonstrated that p300-mediated acetylation of SERCA2a is a critical PTM that decreases the pump's function and contributes to cardiac impairment in HF. SERCA2a acetylation can be targeted for therapeutic aims for the treatment of HF.
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Affiliation(s)
- Przemek A. Gorski
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ahyoung Lee
- Research Institute for Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea
| | - Philyoung Lee
- New Drug Development Center, Osong Medical Innovation Fundation, Osong, Seoul 02841, Republic of Korea
| | - Jae Gyun Oh
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Peter Vangheluwe
- Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Roger Hajjar
- Phospholamban Foundation, 1775 ZH Amsterdam, The Netherlands
| | - Changwon Kho
- Division of Applied Medicine, School of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea
- Correspondence: ; Tel.: +82-51-510-8467
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18
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Romeo FJ, Mazurek R, Sakata T, Mavropoulos SA, Ishikawa K. Device-Based Approaches Targeting Cardioprotection in Myocardial Infarction: The Expanding Armamentarium of Innovative Strategies. J Am Heart Assoc 2022; 11:e026474. [PMID: 36382949 PMCID: PMC9851452 DOI: 10.1161/jaha.122.026474] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Coronary reperfusion therapy has played a pivotal role for reducing mortality and heart failure after acute myocardial infarction. Although several adjunctive approaches have been studied for reducing infarct size further, both ischemia-reperfusion injury and microvascular obstruction are still major contributors to both early and late clinical events after acute myocardial infarction. The progress in the field of cardioprotection has found several promising proof-of-concept preclinical studies. However, translation from bench to bedside has not been very successful. This comprehensive review discusses the importance of infarct size as a driver of clinical outcomes post-acute myocardial infarction and summarizes recent novel device-based approaches for infarct size reduction. Device-based interventions including mechanical cardiac unloading, myocardial cooling, coronary sinus interventions, supersaturated oxygen therapy, and vagal stimulation are discussed. Many of these approaches can modify ischemic myocardial biology before reperfusion and offer unique opportunities to target ischemia-reperfusion injury.
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Affiliation(s)
- Francisco José Romeo
- Cardiovascular Research InstituteIcahn School of Medicine at Mount SinaiNew YorkNY
| | - Renata Mazurek
- Cardiovascular Research InstituteIcahn School of Medicine at Mount SinaiNew YorkNY
| | - Tomoki Sakata
- Cardiovascular Research InstituteIcahn School of Medicine at Mount SinaiNew YorkNY
| | | | - Kiyotake Ishikawa
- Cardiovascular Research InstituteIcahn School of Medicine at Mount SinaiNew YorkNY
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19
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Inada M, Nishimura Y, Ishikura S, Ishikawa K, Murakami N, Kodaira T, Ito Y, Tsuchiya K, Murakami Y, Saitoh J, Akimoto T, Nakata K, Yoshimura M, Teshima T, Toshiyasu T, Ota Y, Minemura T, Shimizu H, Hiraoka M. The Organs-at-Risk Dose Constraints in Head and Neck Intensity Modulated Radiation Therapy Using Data from a Multi-Institutional Clinical Trial (JCOG1015A1). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1346] [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: 10/31/2022]
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20
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Badimon JJ, Santos-Gallego CG, Requena-Ibanez JA, Picatoste B, Fardman B, Ishikawa K, Mazurek R, Pieper M, Fuster V. Cardioprotective effect of empagliflozin in acute myocardial infarction: the role of ketone bodies availability. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1372] [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
Background
The cardio-renal benefits of SGLT2i have been clearly established by clinical trials. Of interest, despite not having any effect on the incidence of classic atherothrombotic events (MI and strokes), patients receiving SGLT2i treatment had a higher chance of surviving myocardial infarction (MI).
Purpose
We aim to evaluate the cardioprotective potential of empagliflozin on acute myocardial infarction.
We postulate that the benefits of SGLT2-I are mediated via an increase in circulating ketone bodies (KBs) induced by SGLT2i, and its preferential myocardial utilization energetically benefits the heart to better withstand an ischemic event.
Methods
The study was undertaken in our non-diabetic porcine model of ischemia/reperfusion. Animals were allocated to either one-week pre-treatment with empagliflozin or placebo before MI-induction. A third group received IV infusion of KBs at the time of the MI- induction to serve as positive-control. The acute effects of the treatments were studied 24 hours after MI-induction by Cardiac Magnetic Resonance (CMR). Immediately post-CMR, animals were sacrificed and heart samples collected for molecular analysis.
Results
(see Table and Figure): Despite similar initial ischemic injury (area at risk) in all groups, empagliflozin was associated with a significantly higher myocardial salvage (MSI 23.7±9.7 vs 4.5±3.6%, p<0.001) and better preserved cardiac function (LVEF 41.3±3.1 vs 33±5.5%, p<0.009) compared with placebo. The infusion of KBs replicated in part the beneficial profile of the empagliflozin group (MSI 16.7±8.8 and LVEF 39.1±3.6%). Histological analysis showed less cardiomyocyte apoptosis and less oxidative stress
Conclusions
To the best of our knowledge, this is the first study evaluating in vivo the cardioprotective potential of a SGLT2 inhibitor in a well-stablished porcine translational model. Furthermore, effects are evaluated using the gold standard for visualization and quantification of MI, Cardiac Magnetic Resonance (CMR). Three are the main conclusions:
1. One-week treatment with empagliflozin raises circulating KBs levels and confers significant cardio-protection during a myocardial infarction. Acute post-MI benefits (greater myocardial salvage and better preserved cardiac function) are already seen within 24 hours as compared with placebo.
2. Periprocedural IV infusion of KBs induces similar benefits than the SGLT2-I group.
3. These observations strongly support our hypothesis that SGLT2 inhibition is associated with increased circulating KBs and its selective use as preferential myocardial source of energy as a potential mechanism of action involved in the cardio-renal benefits observed with SGLT2i.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Spanish Society of Cardiology. Research Fellowship Grant.
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Affiliation(s)
- J J Badimon
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - C G Santos-Gallego
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - J A Requena-Ibanez
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - B Picatoste
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - B Fardman
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - K Ishikawa
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - R Mazurek
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - M Pieper
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - V Fuster
- Icahn School of Medicine at Mount Sinai, Boehringer Ingelheim. Cardiometabolic Diseases Research. Germany. , New York , United States of America
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21
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Fertig B, Ling J, Nollet EE, Dobi S, Busiau T, Ishikawa K, Yamada K, Lee A, Kho C, Wills L, Tibbo AJ, Scott M, Grant K, Campbell KS, Birks EJ, MacQuaide N, Hajjar R, Smith GL, van der Velden J, Baillie GS. SUMOylation does not affect cardiac troponin I stability but alters indirectly the development of force in response to Ca 2. FEBS J 2022; 289:6267-6285. [PMID: 35633070 PMCID: PMC9588612 DOI: 10.1111/febs.16537] [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: 05/19/2021] [Revised: 03/21/2022] [Accepted: 05/26/2022] [Indexed: 11/27/2022]
Abstract
Post-translational modification of the myofilament protein troponin I by phosphorylation is known to trigger functional changes that support enhanced contraction and relaxation of the heart. We report for the first time that human troponin I can also be modified by SUMOylation at lysine 177. Functionally, TnI SUMOylation is not a factor in the development of passive and maximal force generation in response to calcium, however this modification seems to act indirectly by preventing SUMOylation of other myofilament proteins to alter calcium sensitivity and cooperativity of myofilaments. Utilising a novel, custom SUMO site-specific antibody that recognises only the SUMOylated form of troponin I, we verify that this modification occurs in human heart and that it is upregulated during disease.
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Affiliation(s)
- Bracy Fertig
- Institute of Cardiovascular and Medical Sciences, College of Veterinary, Medical and Life SciencesGlasgow UniversityUK
| | - Jiayue Ling
- Institute of Cardiovascular and Medical Sciences, College of Veterinary, Medical and Life SciencesGlasgow UniversityUK
| | - Edgar E. Nollet
- Department of Physiology, Amsterdam UMC, Amsterdam Cardiovascular SciencesVrije Universiteit AmsterdamThe Netherlands
| | - Sara Dobi
- Institute of Cardiovascular and Medical Sciences, College of Veterinary, Medical and Life SciencesGlasgow UniversityUK
| | - Tara Busiau
- Institute of Cardiovascular and Medical Sciences, College of Veterinary, Medical and Life SciencesGlasgow UniversityUK
| | | | - Kelly Yamada
- Cardiovascular Research CentreIcahn School of MedicineNew YorkNYUSA
| | - Ahyoung Lee
- Cardiovascular Research CentreIcahn School of MedicineNew YorkNYUSA
| | - Changwon Kho
- Division of Applied MedicinePusan National UniversityKorea
| | - Lauren Wills
- Department of NeuroscienceIchan School of MedicineNew YorkNYUSA
| | - Amy J. Tibbo
- Institute of Cardiovascular and Medical Sciences, College of Veterinary, Medical and Life SciencesGlasgow UniversityUK
| | - Mark Scott
- INSERM, U1016, Institut CochinParisFrance
| | - Kirsten Grant
- Department of Clinical BiochemistryGlasgow Royal InfirmaryUK
| | - Kenneth S. Campbell
- Department of PhysiologyUniversity of KentuckyLexingtonKYUSA
- Division of Cardiovasuclar MedicineUniversity of KentuckyLexingtonKYUSA
| | - Emma J. Birks
- Division of Cardiovasuclar MedicineUniversity of KentuckyLexingtonKYUSA
| | - Niall MacQuaide
- School of Health and Life SciencesGlasgow Caledonian UniversityUK
| | | | - Godfrey L. Smith
- Institute of Cardiovascular and Medical Sciences, College of Veterinary, Medical and Life SciencesGlasgow UniversityUK
| | - Jolanda van der Velden
- Department of Physiology, Amsterdam UMC, Amsterdam Cardiovascular SciencesVrije Universiteit AmsterdamThe Netherlands
- Netherlands Heart InstituteUtrechtThe Netherlands
| | - George S. Baillie
- Institute of Cardiovascular and Medical Sciences, College of Veterinary, Medical and Life SciencesGlasgow UniversityUK
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22
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Li J, Kelly SC, Ivey JR, Thorne PK, Yamada KP, Aikawa T, Mazurek R, Turk JR, Silva KAS, Amin AR, Tharp DL, Mueller CM, Thakur H, Leary EV, Domeier TL, Rector RS, Fish K, Cividini F, Ishikawa K, Emter CA, Kapiloff MS. Distribution of cardiomyocyte-selective adeno-associated virus serotype 9 vectors in swine following intracoronary and intravenous infusion. Physiol Genomics 2022; 54:261-272. [PMID: 35648460 PMCID: PMC9236866 DOI: 10.1152/physiolgenomics.00032.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Indexed: 11/22/2022] Open
Abstract
Limited reports exist regarding adeno-associated virus (AAV) biodistribution in swine. This study assessed biodistribution following antegrade intracoronary and intravenous delivery of two self-complementary serotype 9 AAV (AAV9sc) biologics designed to target signaling in the cardiomyocyte considered important for the development of heart failure. Under the control of a cardiomyocyte-specific promoter, AAV9sc.shmAKAP and AAV9sc.RBD express a small hairpin RNA for the perinuclear scaffold protein muscle A-kinase anchoring protein β (mAKAPβ) and an anchoring disruptor peptide for p90 ribosomal S6 kinase type 3 (RSK3), respectively. Quantitative PCR was used to assess viral genome (vg) delivery and transcript expression in Ossabaw and Yorkshire swine tissues. Myocardial viral delivery was 2-5 × 105 vg/µg genomic DNA (gDNA) for both infusion techniques at a dose ∼1013 vg/kg body wt, demonstrating delivery of ∼1-3 viral particles per cardiac diploid genome. Myocardial RNA levels for each expressed transgene were generally proportional to dose and genomic delivery, and comparable with levels for moderately expressed endogenous genes. Despite significant AAV9sc delivery to other tissues, including the liver, neither biologic induced toxic effects as assessed using functional, structural, and circulating cardiac and systemic markers. These results indicate successful targeted delivery of cardiomyocyte-selective viral vectors in swine without negative side effects, an important step in establishing efficacy in a preclinical experimental setting.
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Affiliation(s)
- Jinliang Li
- Department of Ophthalmology, Stanford University, Palo Alto, California
- Department of Medicine, Stanford Cardiovascular Institute, Stanford University, Palo Alto, California
| | - Shannon C Kelly
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - Jan R Ivey
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - Pamela K Thorne
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - Kelly P Yamada
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Tadao Aikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Renata Mazurek
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - James R Turk
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | | | - Amira R Amin
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - Darla L Tharp
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - Christina M Mueller
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - Hrishikesh Thakur
- Department of Ophthalmology, Stanford University, Palo Alto, California
- Department of Medicine, Stanford Cardiovascular Institute, Stanford University, Palo Alto, California
| | - Emily V Leary
- Department of Orthopedic Surgery, University of Missouri, Columbia, Missouri
| | - Timothy L Domeier
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - R Scott Rector
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, Missouri
- Research Service, Harry S. Truman Memorial VA Hospital, University of Missouri, Columbia, Missouri
| | - Kenneth Fish
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, New York
| | | | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Craig A Emter
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - Michael S Kapiloff
- Department of Ophthalmology, Stanford University, Palo Alto, California
- Department of Medicine, Stanford Cardiovascular Institute, Stanford University, Palo Alto, California
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Emelyanenko AV, Rudyak VY, Shvetsov SA, Araoka F, Nishikawa H, Ishikawa K. Emergence of paraelectric, improper antiferroelectric, and proper ferroelectric nematic phases in a liquid crystal composed of polar molecules. Phys Rev E 2022; 105:064701. [PMID: 35854528 DOI: 10.1103/physreve.105.064701] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/13/2022] [Indexed: 05/15/2023]
Abstract
We have elaborated a theoretical approach for the description of polar nematic phases observed by Nishikawa et al. [Adv. Mater. 29, 1702354 (2017)0935-964810.1002/adma.201702354], their structures, and transitions between them. Specific symmetry contributions to the pair molecular potentials provide the molecular mechanisms responsible for the formation of proper and improper polarity on the macroscopic level. An improper antiferroelectric nematic M2 phase can arise between paraelectric nematic M1 and proper ferroelectric nematic MP in the temperature scale. The local polarization in M2 arises mostly due to the local splay deformation. The director distribution in M2 represents the conjugation of cylindrical waves with opposite splay and polarization signs. The director and polarization are parallel to the cylindrical domain axes in the middle of each cylinder but exhibit considerable (mostly radial) deformation on the periphery of each cylinder. Polarization vectors are mostly stacked antiparallel on the borders between the domains without the director disruption. The domain size decreases with the decreasing temperature, the percentage of the antiferroelectric decouplings increases, and M2 exhibits the first-order phase transition into proper ferroelectric MP. With the increasing temperature the domain size in the M2 phase increases, the domination of particular polar orientation of molecules reduces, and finally, the domain size diverges at particular temperature corresponding to the second-order phase transition from M2 to paraelectric M1. Variations of the polar and nonpolar orientational order parameters are estimated within each phase and between the phases. Our experimental and computer simulation results (also presented in the paper) fully support our theoretical findings.
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Affiliation(s)
| | - V Yu Rudyak
- Lomonosov Moscow State University, Moscow 119991, Russia
| | - S A Shvetsov
- Lomonosov Moscow State University, Moscow 119991, Russia
- Lebedev Physical Institute, Moscow 119991, Russia
| | - F Araoka
- RIKEN Center for Emergent Matter Science (CEMS), 2-1 Hirosawa Wako, Saitama 351-0198, Japan
| | - H Nishikawa
- RIKEN Center for Emergent Matter Science (CEMS), 2-1 Hirosawa Wako, Saitama 351-0198, Japan
| | - K Ishikawa
- Tokyo Institute of Technology, 2-12-1 Ookayama, Meguro-ku, Tokyo 152-8550, Japan
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24
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Hayashi K, Sasaki H, Mugita T, Tomiyama T, Koizumi S, Kurokawa I, Matsubara E, Saito K, Fuji K, Ishikawa K, Fukagai T. Effect of long-term administration of Tadalafil on arteriosclerosis: A prospective cohort study. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.481] [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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25
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Hayashi K, Sasaki H, Mugita T, Tomiyama T, Koizumi S, Kurokawa I, Saito K, Fuji K, Ishikawa K, Fukagai T. Association between vascular lesion and penile erection hardness in Japanese patients with erectile dysfunction. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.455] [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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26
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Ishikawa K, Sasaki H, Ogushi Y, Niikura A, Ota T, Ichimura Y, Hashimoto Y, Kurokawa I, Sugishita H, Tanifuji S, Yamagishi M, Shimoyama H, Ota M, Oshinomi K, Hayashi K, Morita J, Shichijo T, Fukagai T, Sugawara S. Lipid abnormality, current diabetes and age affect erectile hardness ∼ An analysis of data from complete medical checkups performed at a single hospital in Japan. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.421] [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: 11/16/2022]
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27
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Yamagishi M, Sasaki H, Ogushi Y, Niikura A, Ota T, Ichimura Y, Hashimoto Y, Sugishita H, Kurokawa I, Tanifuji S, Imamura Y, Shimoyama H, Ota M, Ishikawa K, Hayashi K, Fukagai T. A study of erectile dysfunction in men 40 years of age or younger. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.422] [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: 11/26/2022]
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28
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Shimoyama H, Sasaki H, Ogushi Y, Niikura A, Ota T, Ichimura Y, Hshimoto Y, Kurokawa I, Sugishita H, Tanifuji S, Yamagishi M, Imamura Y, Ota M, Ishikawa K, Hayashi K. Clinical analysis on the pharmaceutical formulation of VIAGRA OD Film. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.434] [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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29
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Sakata T, Mazurek R, Mavropoulos SA, Romeo F, Ravichandran AJ, Watanabe S, Kariya T, Ishikawa K. Left Atrial Remodeling and Dysfunction in Swine Models of Mitral Regurgitation. Am J Physiol Heart Circ Physiol 2022; 322:H914-H923. [PMID: 35333115 DOI: 10.1152/ajpheart.00009.2022] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Left atrial (LA) dysfunction is one of the predictive factors of worse outcomes after mitral valve surgery for mitral regurgitation (MR). We aimed to investigate the effect of MR etiology on progression of LA remodeling in swine MR models. METHODS MR was induced in 14 Yorkshire pigs using catheter-based procedures. Seven pigs underwent simultaneous occlusions of the left circumflex artery and the diagonal branch, which resulted in ischemic MR (IMR group). The other seven pigs underwent chordal severing to induce leaflet prolapse simulating degenerative MR (DMR group). Changes in LA volume and function were assessed at baseline, 1 and 3 months using echocardiography and hemodynamic evaluations. Histopathological assessments were conducted to evaluate LA hypertrophy and fibrosis. RESULTS At 3 months, quantitative MR severity was comparable and severe in both groups. Despite the similar degree of MR, minimum LA volume index increased significantly more in the IMR group (IMR: 11.9±6.4 to 73.2±6.4, DMR: 10.7±6.4 to 29.5±6.4 ml/m2, pinteraction=0.004). Meanwhile, increase in maximum LA volume index was similar between the groups, resulting in lower LA emptying function in the IMR group (IMR: 60.1±3.1 to 29.4±3.1, DMR: 62.4±3.1 to 58.2±3.1%, pinteraction=0.0003). LA reservoir strain assessed by echocardiography was also significantly lower in the IMR group. Histological analyses revealed increased LA cellular hypertrophy and fibrosis in the IMR group. CONCLUSIONS Ischemic MR is associated with aggressive remodeling and reduced emptying function compared to MR due to leaflet prolapse. Earlier intervention might be necessary for ischemic MR to prevent LA remodeling.
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Affiliation(s)
- Tomoki Sakata
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Renata Mazurek
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Spyros A Mavropoulos
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Francisco Romeo
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Anjali J Ravichandran
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Shin Watanabe
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Taro Kariya
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Bikou O, Tharakan S, Yamada K, Kariya T, Aguero J, Gordon A, Mazurek R, Aikawa T, Kohlbrenner E, Fish K, Hajjar RJ, Ishikawa K. Endo-bronchial aerosolized AAV1.SERCA2a gene therapy in a pulmonary hypertension pig model: addressing the lung delivery bottleneck. Hum Gene Ther 2022; 33:550-559. [PMID: 35293228 PMCID: PMC9142769 DOI: 10.1089/hum.2021.274] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A disappointing number of new therapies for pulmonary hypertension (PH) have been successfully translated to the clinic. Adeno-associated viral (AAV) gene therapy has the potential to treat the underlying pathology of PH, but the challenge remains in efficient and safe delivery. The aims of this study were i) to test the efficacy of endo-bronchial aerosolization delivery for AAV1-mediated sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2a (SERCA2a) gene therapy in a PH pig model and ii) to identify the most efficient airway administration modality for in-lung gene therapy in PH. We hypothesized that delivery to the distal bronchi increases lung viral uptake and avoids virus loss in off-target compartments. In part one of the study, PH was induced in pigs by surgically banding the pulmonary veins. Two months post-surgery, 1x1013 viral genomes (vg) of AAV1.SERCA2a or saline was endo-bronchially aerosolized using a bronchoscope. Two months after aerosolization, high vg copies were detected in the lungs, accompanied by functional and morphometrical amelioration of PH. In part two of the study, we directly compared the endo-bronchial aerosolization gene delivery to the intra-tracheal aerosolization in PH pigs. Endo-bronchial delivery demonstrated higher viral expression (6,719 ± 927 vs 1,444 ± 402 vg copy/100ng DNA, p=0.0017), suggesting this delivery modality is a promising method for clinical AAV gene therapy for PH.
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Affiliation(s)
- Olympia Bikou
- Icahn School of Medicine at Mount Sinai, 5925, Cardiovascular Institute, New York, New York, United States;
| | - Serena Tharakan
- Icahn School of Medicine at Mount Sinai, 5925, Cardiovascular Institute, New York, New York, United States;
| | - Kelly Yamada
- Icahn School of Medicine at Mount Sinai, 5925, Cardiovascular Institute, New York, New York, United States;
| | - Taro Kariya
- Icahn School of Medicine at Mount Sinai, 5925, Cardiovascular Institute, New York, New York, United States;
| | - Jaume Aguero
- Icahn School of Medicine at Mount Sinai, 5925, Cardiovascular Institute, New York, New York, United States;
| | - Alexandra Gordon
- Icahn School of Medicine at Mount Sinai, 5925, Cardiovascular Institute, New York, New York, United States;
| | - Renata Mazurek
- Icahn School of Medicine at Mount Sinai, 5925, Cardiovascular Institute, New York, New York, United States;
| | - Tadao Aikawa
- Icahn School of Medicine at Mount Sinai, 5925, Cardiovascular Institute, New York, New York, United States;
| | - Erik Kohlbrenner
- Icahn School of Medicine at Mount Sinai, 5925, Cardiovascular Institute, New York, New York, United States;
| | - Kenneth Fish
- Icahn School of Medicine at Mount Sinai, 5925, Cardiovascular Institute, New York, New York, United States;
| | | | - Kiyotake Ishikawa
- Icahn School of Medicine at Mount Sinai, 5925, Cardiovascular Institute, One Gustave L. Levy Place Box 1030, New York, New York, United States, 10029;
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31
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Sakata T, Watanabe S, Mazurek R, Mavropoulos S, Romeo F, Yamada KP, Ishikawa K. Impaired Diastolic Function Predicts Improved Ischemic Myocardial Flow by Mechanical Left Ventricular Unloading in a Swine Model of Ischemic Heart Failure. Front Cardiovasc Med 2022; 8:795322. [PMID: 35097014 PMCID: PMC8790047 DOI: 10.3389/fcvm.2021.795322] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Impact of mechanical left ventricular (LV) unloading on myocardial tissue perfusion and its regulating factors remain unclear. This study was conducted to elucidate the predictors of regional blood flow (RBF) improvement by mechanical LV unloading. Materials and Methods: One to four weeks after percutaneous induction of myocardial infarction (MI), Yorkshire pigs (n = 15) underwent mechanical LV unloading using Impella CP. Hemodynamic parameters were collected prior to LV unloading. RBF in infarct, border and remote myocardium were measured by fluorescent microsphere injections before and 120 min after LV unloading. Results: RBF showed variable responses to mechanical LV unloading. While infarct RBF improved in general (0.33 ± 0.13 to 0.42 ± 0.19 mL/min/g, p = 0.06), there were a few pigs that showed little improvement. Meanwhile, there were no clear trends in the border (1.07 ± 0.47 to 1.02 ± 0.65 mL/min/g, p = 0.73) and remote myocardial RBF (1.25 ± 0.52 to 1.23 ± 0.68 mL/min/g, p = 0.85). In the simple linear regression analysis, cardiac output, mean pulmonary arterial wedge pressure, mean left atrial pressure, minimum LV pressure, end-diastolic LV pressure, maximum dP/dt, slope of end-diastolic pressure-volume relationship (EDPVR) and end-diastolic wall stress were significantly associated with % change of infarct RBF. In the multiple regression model, slope of EDPVR and maximum dP/dt remained as independent predictors of infarct RBF change. Conclusion: Steeper EDPVR and lower maximum dP/dt were associated with increased blood perfusion in the infarct area after LV unloading. Our data suggests mechanical LV unloading is more beneficial in post-MI patients with high diastolic pressure associated with increased LV stiffness and in those with worse cardiac contractility.
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32
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Koplev S, Seldin M, Sukhavasi K, Ermel R, Pang S, Zeng L, Bankier S, Di Narzo A, Cheng H, Meda V, Ma A, Talukdar H, Cohain A, Amadori L, Argmann C, Houten SM, Franzén O, Mocci G, Meelu OA, Ishikawa K, Whatling C, Jain A, Jain RK, Gan LM, Giannarelli C, Roussos P, Hao K, Schunkert H, Michoel T, Ruusalepp A, Schadt EE, Kovacic JC, Lusis AJ, Björkegren JLM. A mechanistic framework for cardiometabolic and coronary artery diseases. Nat Cardiovasc Res 2022; 1:85-100. [PMID: 36276926 PMCID: PMC9583458 DOI: 10.1038/s44161-021-00009-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Coronary atherosclerosis results from the delicate interplay of genetic and exogenous risk factors, principally taking place in metabolic organs and the arterial wall. Here we show that 224 gene-regulatory coexpression networks (GRNs) identified by integrating genetic and clinical data from patients with (n = 600) and without (n = 250) coronary artery disease (CAD) with RNA-seq data from seven disease-relevant tissues in the Stockholm-Tartu Atherosclerosis Reverse Network Engineering Task (STARNET) study largely capture this delicate interplay, explaining >54% of CAD heritability. Within 89 cross-tissue GRNs associated with clinical severity of CAD, 374 endocrine factors facilitated inter-organ interactions, primarily along an axis from adipose tissue to the liver (n = 152). This axis was independently replicated in genetically diverse mouse strains and by injection of recombinant forms of adipose endocrine factors (EPDR1, FCN2, FSTL3 and LBP) that markedly altered blood lipid and glucose levels in mice. Altogether, the STARNET database and the associated GRN browser (http://starnet.mssm.edu) provide a multiorgan framework for exploration of the molecular interplay between cardiometabolic disorders and CAD.
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Affiliation(s)
- Simon Koplev
- Department of Genetics and Genomic Sciences, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Marcus Seldin
- Departments of Medicine, Human Genetics and Microbiology, Immunology & Molecular Genetics, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Biological Chemistry and Center for Epigenetics and Metabolism, University of California, Irvine, CA, USA
| | - Katyayani Sukhavasi
- Department of Cardiac Surgery and the Heart Clinic, Tartu University Hospital and Department of Cardiology, Institute of Clinical Medicine, Tartu University, Tartu, Estonia
| | - Raili Ermel
- Department of Cardiac Surgery and the Heart Clinic, Tartu University Hospital and Department of Cardiology, Institute of Clinical Medicine, Tartu University, Tartu, Estonia
| | - Shichao Pang
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Technische Universität München, DZHK (German Centre for Cardiovascular Research), Munich Heart Alliance, Munich, Germany
| | - Lingyao Zeng
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Technische Universität München, DZHK (German Centre for Cardiovascular Research), Munich Heart Alliance, Munich, Germany
| | - Sean Bankier
- BHF Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
- Computational Biology Unit, Department of Informatics, University of Bergen, Bergen, Norway
| | - Antonio Di Narzo
- Department of Genetics and Genomic Sciences, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Haoxiang Cheng
- Department of Genetics and Genomic Sciences, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Vamsidhar Meda
- Department of Genetics and Genomic Sciences, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Angela Ma
- Department of Genetics and Genomic Sciences, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Husain Talukdar
- Department of Medicine, Karolinska Institutet, Karolinska Universitetssjukhuset, Huddinge, Sweden
| | - Ariella Cohain
- Department of Genetics and Genomic Sciences, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Letizia Amadori
- Department of Genetics and Genomic Sciences, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- New York University Cardiovascular Research Center, Department of Medicine, Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, USA
| | - Carmen Argmann
- Department of Genetics and Genomic Sciences, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sander M. Houten
- Department of Genetics and Genomic Sciences, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Oscar Franzén
- Department of Medicine, Karolinska Institutet, Karolinska Universitetssjukhuset, Huddinge, Sweden
| | - Giuseppe Mocci
- Department of Medicine, Karolinska Institutet, Karolinska Universitetssjukhuset, Huddinge, Sweden
| | - Omar A. Meelu
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carl Whatling
- Translational Science and Experimental Medicine, Research and Early Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Anamika Jain
- Department of Cardiac Surgery and the Heart Clinic, Tartu University Hospital and Department of Cardiology, Institute of Clinical Medicine, Tartu University, Tartu, Estonia
| | - Rajeev Kumar Jain
- Department of Cardiac Surgery and the Heart Clinic, Tartu University Hospital and Department of Cardiology, Institute of Clinical Medicine, Tartu University, Tartu, Estonia
| | - Li-Ming Gan
- Early Clinical Development, Research and Early Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Chiara Giannarelli
- Department of Genetics and Genomic Sciences, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- New York University Cardiovascular Research Center, Department of Medicine, Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, USA
| | - Panos Roussos
- Department of Genetics and Genomic Sciences, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Dementia Research, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
- Mental Illness Research Education and Clinical Center (MIRECC), James J. Peters VA Medical Center, Bronx, NY, USA
| | - Ke Hao
- Department of Genetics and Genomic Sciences, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Sema4, Stamford, CT, USA
| | - Heribert Schunkert
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Technische Universität München, DZHK (German Centre for Cardiovascular Research), Munich Heart Alliance, Munich, Germany
| | - Tom Michoel
- Computational Biology Unit, Department of Informatics, University of Bergen, Bergen, Norway
| | - Arno Ruusalepp
- Department of Cardiac Surgery and the Heart Clinic, Tartu University Hospital and Department of Cardiology, Institute of Clinical Medicine, Tartu University, Tartu, Estonia
- Clinical Gene Networks AB, Stockholm, Sweden
| | - Eric E. Schadt
- Department of Genetics and Genomic Sciences, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Sema4, Stamford, CT, USA
| | - Jason C. Kovacic
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia
- St Vincent’s Clinical School, University of NSW, Sydney, New South Wales, Australia
| | - Aldon J. Lusis
- Departments of Medicine, Human Genetics and Microbiology, Immunology & Molecular Genetics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Johan L. M. Björkegren
- Department of Genetics and Genomic Sciences, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Karolinska Institutet, Karolinska Universitetssjukhuset, Huddinge, Sweden
- Clinical Gene Networks AB, Stockholm, Sweden
- Correspondence and requests for materials should be addressed to Johan L. M. Björkegren.
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Mazurek R, Ishikawa K. ELISpot Assay for Gene Therapy in Large Animal Studies. Methods Mol Biol 2022; 2573:323-332. [PMID: 36040606 DOI: 10.1007/978-1-0716-2707-5_25] [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] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Formation of neutralizing antibodies and cellular immune response with repeat adeno-associated virus (AAV) gene therapy dosing are critical concerns in translational, large animal studies. The enzyme-linked immunospot/immunosorbent spot (ELISpot) assay introduced a way to track B- and/or T-cell response to therapy over time at a protein level. We describe the protocol for this assay looking at relative interferon (IFN)-γ secretion in pre- and post-AAV injections in a pig model.
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Affiliation(s)
- Renata Mazurek
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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34
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Ravichandran AJ, Mazurek R, Ishikawa K. Cell-Based Determination of Neutralizing Antibodies Against Adeno-Associated Virus in Cardiac Gene Therapy. Methods Mol Biol 2022; 2573:293-304. [PMID: 36040603 DOI: 10.1007/978-1-0716-2707-5_22] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The field of cardiac gene therapy has seen the rising use of adeno-associated viral (AAV) vectors as a promising therapeutic option for cardiac diseases and heart failure. To achieve intended results of AAV delivery, a majority of clinical studies screen patients for existing neutralizing antibodies that could inhibit the effects of the administered AAV and confound treatment efficacy. The cell-based neutralizing antibody assay offers a method of quantifying and identifying a patient's existing neutralizing antibodies against specific serotypes. Combined with the luciferase assay, the neutralizing antibody assay tests the ability of patient antibodies in the blood to prevent gene transduction of AAV-encoded luciferase gene at ranging serial dilutions. This chapter provides a protocol and experimental techniques to determine the presence of neutralizing antibodies against AAV in the blood.
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Affiliation(s)
- Anjali J Ravichandran
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Renata Mazurek
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Sakata T, Mazurek R, Mavropoulos SA, Romeo FJ, Ravichandran AJ, Ishikawa K. Assessing the Effect of Cardiac Gene Therapy Using Catheter-Based Pressure-Volume Measurement in Large Animals. Methods Mol Biol 2022; 2573:313-321. [PMID: 36040605 DOI: 10.1007/978-1-0716-2707-5_24] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Gene therapy for heart failure targets various pathways that modulate cardiac function. Its detailed evaluation is crucial for proving the efficacy of cardiac gene therapies. Parameters that can be obtained by noninvasive approaches are generally influenced by loading conditions of the heart. In contrast, catheter-based left ventricular pressure-volume assessment provides a unique option to minimally invasively assess intrinsic myocardial function in a load-insensitive manner. In this chapter, we describe procedural steps for performing pressure-volume measurements and analysis in a preclinical large animal model.
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Affiliation(s)
- Tomoki Sakata
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Renata Mazurek
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Spyros A Mavropoulos
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Francisco J Romeo
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anjali J Ravichandran
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Hosonuma M, Isozaki T, Furuya H, Yamazaki Y, Ikari Y, Nishimi S, Ishii S, Maeoka A, Tokunaga T, Wakabayashi K, Konishi N, Fukuse S, Ishikawa K, Sakai N, Inagaki K, Kasama T. AB0065 HGF/C-MET SIGNALING PROMOTE ANGIOGENESIS THROUGH CXCL16 IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Hepatocyte growth factor (HGF) binds to the receptor tyrosine kinase c-Met and is a multifunctional cytokine that promotes processes such as cell proliferation, survival, differentiation, migration and angiogenesis [1]. We previously reported that HGF is produced by inflammation in the RA synovium, and activates monocyte migration to the synovium and promotes bone destruction through its own chemotactic effect and enhanced chemokine production in the synovium [2].Objectives:Therefore, we next aimed to determine the role of HGF in RA angiogenesis.Methods:The expression of HGF / c-Met in the serum and synovial tissues (STs) of RA patients and controls and human umbilical vein endothelial cells (HUVECs) was evaluated by ELISA and immunostaining. The effect of HGF/c-Met signaling on the promotion of CXCL16 production from HUVECs and RA fibroblast-like synoviocytes (FLSs) was determined by ELISA. To examine the role of HGF in angiogenesis, we performed in vitro Matrigel assays using HUVECs treated with HGF.Results:HGF in serum in treatment-naive RA patients was significantly higher than that in controls and HGF in serum in treatment-resistant RA showed a significant positive correlation with CXCL16. c-Met were expressed on vascular endothelial cells of RA STs and HUVECs. Stimulation of HUVECs with HGF dose-dependently increased CXCL16 production. c-Met signal inhibition by SU11274 suppressed TNF-α stimulation-enhanced CXCL16 production by RA FLSs in a dose-dependent manner. Furthermore, HGF induced HUVEC tube formation by 1.8-fold.Conclusion:HGF is produced by inflammation in the RA synovium, and activates angiogenesis through its own potent angiogenic effect and enhanced production of CXCL16 in the synovium. These results indicate that a strategy targeting c-Met signalling may be important for resolving treatment-resistant RA.References:[1]Nakamura T, Nishizawa T, Hagiya M, et al. Molecular cloning and expression of human hepatocyte growth factor. Nature. 1989 Nov 23;342(6248):440-3.[2]Hosonuma M, Sakai N, Furuya H, et al. Inhibition of hepatocyte growth factor/c-Met signalling abrogates joint destruction by suppressing monocyte migration in rheumatoid arthritis. Rheumatology (Oxford). 2021 Jan 5;60(1):408-419.Disclosure of Interests:None declared
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Abstract
For therapeutic materials to be successfully delivered to the heart, several barriers need to be overcome, including the anatomical challenges of access, the mechanical force of the blood flow, the endothelial barrier, the cellular barrier and the immune response. Various vectors and delivery methods have been proposed to improve the cardiac-specific uptake of materials to modify gene expression. Viral and non-viral vectors are widely used to deliver genetic materials, but each has its respective advantages and shortcomings. Adeno-associated viruses have emerged as one of the best tools for heart-targeted gene delivery. In addition, extracellular vesicles, including exosomes, which are secreted by most cell types, have gained popularity for drug delivery to several organs, including the heart. Accumulating evidence suggests that extracellular vesicles can carry and transfer functional proteins and genetic materials into target cells and might be an attractive option for heart-targeted delivery. Extracellular vesicles or artificial carriers of non-viral and viral vectors can be bioengineered with immune-evasive and cardiotropic properties. In this Review, we discuss the latest strategies for targeting and delivering therapeutic materials to the heart and how the knowledge of different vectors and delivery methods could successfully translate cardiac gene therapy into the clinical setting.
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Affiliation(s)
- Susmita Sahoo
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Taro Kariya
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kiyotake Ishikawa
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Hosonuma M, Isozaki T, Furuya H, Yamazaki Y, Ikari Y, Nishimi S, Maeoka A, Ishii S, Tokunaga T, Wakabayashi K, Konishi N, Fukuse S, Ishikawa K, Sakai N, Inagaki K, Kasama T. POS0429 INTERLEUKIN-4 ACTIVATES EOSINOPHILS AND CCR3-POSITIVE T HELPER CELLS MIGRATION TO FASCIA AND PROMOTES FIBROSIS IN EOSINOPHILIC FASCIITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Eosinophilic fasciitis (EF) is a rare disease that causes inflammation and fibrosis mainly in the fascia of the extremities with eosinophilia. It has been reported that the hypertrophied fascia in EF shows inflammatory cell infiltration by the lymphocytes and eosinophils and increased expression of fibrosis-related cytokines genes in fibroblast [1]. However, its pathophysiology in the fascia remains unresolved.Objectives:Therefore, we focused on fascial fibroblasts and aimed to determine the role of interleukin-4 (IL-4) in eosinophil and helper T cell infiltration and fibrosis in fascial fibroblast in EF.Methods:Fascial fibroblasts were obtained from fascia biopsy of a patient with EF, and were stimulated with pre- and post-treatment serum of a patient with EF and healthy control, followed by microarray to analyze gene expression. Fascial fibroblasts were stimulated with IL-4 10 ng/mL, and gene expression of IL-4 receptor and CCR3 ligands, CCL7 and CCL11 were measured by qPCR. Transforming growth factor (TGF) -β and periostin in the pre- and post-treatment serum of a patient with EF and conditioned medium of fascial fibroblasts stimulated with IL-4 were measured by ELISA. To examine the role of IL-4 in proliferation, we performed in proliferation assays using fascial fibroblasts treated with IL-4. CCR3-positive T cells in the fascial tissue of EF, dermatomyositis, and polymyositis patients were evaluated by immunostaining.Results:By microarray analysis, CCL7 and CCL11 expression of fascial fibroblasts stimulated with pre-treatment EF serum was higher than that in post-treatment EF serum and control serum. CCL7 and CCL11 mRNA in IL-4 stimulated facial fibroblasts were increased by 5.1-fold and 7.3-fold, respectively. TGF-β and periostin in IL-4 stimulated facial fibroblast conditioned medium were also increased. In addition, TGF-β and periostin in EF serum were gradually decreased by treatment for 4 and 10 weeks, compared to before treatment. Finally, fascial fibroblast proliferation was significantly increased by stimulation with IL-4. Furthermore, infiltration of CCR3-positive T cells was specific to the fascial tissue of EF.Conclusion:In EF, IL-4 enhances the production of CCR3 ligands, TGF-β, and periostin from fascial fibroblasts. As a result, it promotes the migration of eosinophils and CCR3-positive T helper cells to the fascia and fibrosis. These results suggest that inhibition of IL-4 pathway could be a novel strategy for eosinophilic fasciitis.References:[1]Igarashi A, Nashiro K, Kikuchi K, et al. Connective tissue growth factor gene expression in tissue sections from localized scleroderma, keloid, and other fibrotic skin disorders. J Invest Dermatol. 1996 Apr;106(4):729-33.Disclosure of Interests:None declared
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Ishikawa K, Meyns B, Kapur NK. Editorial: Science in Mechanical Circulatory Support. Front Cardiovasc Med 2021; 8:676595. [PMID: 34079830 PMCID: PMC8165192 DOI: 10.3389/fcvm.2021.676595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/14/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Bart Meyns
- Department of Cardiac Surgery, Universitair Ziekenhuis Leuven Gasthuisberg University Hospital, Leuven, Belgium
| | - Navin K Kapur
- The Cardiovascular Center, Tufts Medical Center, Boston, MA, United States
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Kariya T, Yamada KP, Bikou O, Tharakan S, Miyashita S, Ishikawa K. Corrigendum: Novel Porcine Model of Coronary Dissection Reveals the Impact of Impella on Dissected Coronary Arterial Hemodynamics. Front Cardiovasc Med 2021; 8:646675. [PMID: 33898537 PMCID: PMC8062108 DOI: 10.3389/fcvm.2021.646675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 03/17/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
- Taro Kariya
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Kelly P Yamada
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Olympia Bikou
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Serena Tharakan
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Satoshi Miyashita
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Kiyotake Ishikawa
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Yamada KP, Kariya T, Aikawa T, Ishikawa K. Effects of Therapeutic Hypothermia on Normal and Ischemic Heart. Front Cardiovasc Med 2021; 8:642843. [PMID: 33659283 PMCID: PMC7919696 DOI: 10.3389/fcvm.2021.642843] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/16/2020] [Accepted: 01/21/2021] [Indexed: 12/24/2022] Open
Abstract
Therapeutic hypothermia has been used for treating brain injury after out-of-hospital cardiac arrest. Its potential benefit on minimizing myocardial ischemic injury has been explored, but clinical evidence has yet to confirm positive results in preclinical studies. Importantly, therapeutic hypothermia for myocardial infarction is unique in that it can be initiated prior to reperfusion, in contrast to its application for brain injury in resuscitated cardiac arrest patients. Recent advance in cooling technology allows more rapid cooling of the heart than ever and new clinical trials are designed to examine the efficacy of rapid therapeutic hypothermia for myocardial infarction. In this review, we summarize current knowledge regarding the effect of hypothermia on normal and ischemic hearts and discuss issues to be solved in order to realize its clinical application for treating acute myocardial infarction.
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Affiliation(s)
- Kelly P Yamada
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Taro Kariya
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Tadao Aikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Tong Y, Ishikawa K, Sasaki R, Takeshita I, Sakamoto J, Okita M. The effects of wheel-running using the upper limbs following immobilization after inducing arthritis in the knees of rats. Physiol Res 2021; 70:79-87. [PMID: 33453715 DOI: 10.33549/physiolres.934469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study investigated the effects of wheel-running using the upper limbs following immobilization after inducing arthritis in the knees of rats. Forty male Wistar rats (aged 8 weeks) divided into four groups randomly: arthritis (AR), immobilization after arthritis (Im), wheel-running exercise with the upper limbs following immobilization after arthritis induction (Im+Ex) and sham arthritis induction (Con). The knee joints of the Im and Im+Ex groups were immobilized with a cast for 4 weeks. In the Im+Ex group, wheel-running exercise was administered for 60 min/day (5 times/week). The swelling and the pressure pain threshold (PPT) of the knee joint were evaluated for observing the condition of inflammatory symptoms in affected area, and the paw withdraw response (PWR) was evaluated for observing the condition of secondary hyperalgesia in distant area. Especially, in order to evaluate histological inflammation in the knee joint, the number of macrophage (CD68-positive cells) in the synovium was examined. The expression of calcitonin gene-related peptide (CGRP) in the spinal dorsal horn (L2-3 and L4-5) was examined to evaluate central sensitization. The Im+Ex group showed a significantly better recovery than the Im group in the swelling, PPTs, and PWRs. Additionally, CGRP expression of the spinal dorsal horn (L2-3 and L4-5) in the Im+Ex group was significantly decreased compared with the Im group. According to the results, upper limb exercise can decrease pain in the affected area, reduce hyperalgesia in distant areas, and suppress the central sensitization in the spinal dorsal horn by triggering exercise-induced hypoalgesia (EIH).
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Affiliation(s)
- Y Tong
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
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Aikawa T, Kariya T, Yamada KP, Miyashita S, Bikou O, Tharakan S, Fish K, Ishikawa K. Impaired left ventricular global longitudinal strain is associated with elevated left ventricular filling pressure after myocardial infarction. Am J Physiol Heart Circ Physiol 2020; 319:H1474-H1481. [PMID: 33035440 DOI: 10.1152/ajpheart.00502.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Indexed: 12/28/2022]
Abstract
Left ventricular (LV) global longitudinal strain (GLS) has emerged as a significant prognostic marker in patients after myocardial infarction (MI). Although elevated LV filling pressure after MI might alter GLS, direct evidence for this is lacking. This study aimed to clarify the association between GLS and LV filling pressure in a large animal MI model. A total of 104 Yorkshire pigs underwent both echocardiographic and hemodynamic assessments 1-4 wk after induction of large anterior MI. GLS was measured in the apical four-chamber view using a semiautomated speckle-tracking software. LV pressure-volume relationship was invasively measured using a high-fidelity pressure-volume catheter. GLS >-14% was considered impaired. Compared with pigs with LV ejection fraction (LVEF) >40% and preserved GLS (n = 29), those with LVEF >40% and impaired GLS (n = 37) and those with LVEF ≤40% (n = 38) had significantly higher LV end-diastolic pressure (15.5 ± 5.5 vs. 19.7 ± 5.8 and 19.6 ± 6.6 mmHg; P = 0.008 and P = 0.026, respectively) and higher LV mean diastolic pressure (7.1 ± 2.9 vs. 10.4 ± 4.5 and 11.1 ± 5.4 mmHg; P = 0.013 and P = 0.002, respectively). GLS was modestly correlated with τ (r = 0.21, P = 0.039) and slope of LV end-diastolic pressure-volume relationship (r = 0.43, P < 0.001). Impaired GLS was associated with higher LV end-diastolic and mean-diastolic pressures after adjusting for LVEF and baseline characteristics (P = 0.026 and P = 0.001, respectively). Impaired GLS assessed by speckle-tracking echocardiography was associated with elevated LV filling pressure after MI. GLS has an incremental diagnostic value for detecting elevated LV filling pressure and may be particularly useful for evaluating post-MI patients with preserved LVEF.NEW & NOTEWORTHY Strain analysis was performed in 104 pigs after MI, and its relationship to invasive hemodynamic measurements was studied. Impaired longitudinal strain was associated with high ventricular filling pressure independent of LVEF in post-MI setting. Global longitudinal strain is a potential prognostic marker after MI.
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Affiliation(s)
- Tadao Aikawa
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Taro Kariya
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Kelly P Yamada
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Satoshi Miyashita
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Olympia Bikou
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Serena Tharakan
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Kenneth Fish
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Kiyotake Ishikawa
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York City, New York
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Maeda T, Funayama E, Yamamoto Y, Murao N, Osawa M, Ishikawa K, Hayashi T. Long-term outcomes and recurrence-free interval after the treatment of keloids with a standardized protocol. J Tissue Viability 2020; 30:128-132. [PMID: 33288386 DOI: 10.1016/j.jtv.2020.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/29/2020] [Accepted: 11/20/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Recurrence rates of keloids have generally been reported at one time point. However, the longer the duration after treatment, the greater the likelihood that such lesions will recur. In this study, we analysed the time to recurrence during long-term follow-up. MATERIAL AND METHODS We retrospectively reviewed recurrence-free interval in 52 patients with keloid (age 8-79 years) who had been treated between June 2006 and January 2011 using a standardised protocol developed by our group. RESULTS Mean duration of follow-up was 37.5 (range, 7-120) months in patients with keloid. Kaplan-Meier survival curves revealed a statistically significant difference in recurrence-free interval between ear keloids and keloids excluding ear keloids. Recurrence rate for keloids was high in the first 2 years after treatment. CONCLUSIONS Kaplan-Meier analysis was useful for understanding the tendency of recurrence of keloids after treatment using a standardised protocol.
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Affiliation(s)
- T Maeda
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - E Funayama
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Y Yamamoto
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - N Murao
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - M Osawa
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - K Ishikawa
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - T Hayashi
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan; Department of Oral and Maxillofacial Surgery, Graduate School of Dental Medicine, Hokkaido University, Japan.
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Satou T, Kitahara H, Ishikawa K, Nakayama T, Fujimoto Y, Sano K, Kobayashi Y. Short-term risk stratification using CADILLAC risk score in patients with ST elevation myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1352] [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: 11/15/2022] Open
Abstract
Abstract
Background
The recent reperfusion therapy for ST-elevation myocardial infarction (STEMI) has made the length of hospital stay shorter without adverse events. CADILLAC risk score is reportedly one of the risk scores predicting the long-term prognosis in STEMI patients.
Purpose
To invenstigate the usefulness of CADILLAC risk score for predicting short-term outcomes in STEMI patients.
Methods
Consecutive patients admitted to our university hospital and our medical center with STEMI (excluding shock, arrest case) who underwent primary PCI between January 2012 and April 2018 (n=387) were enrolled in this study. The patients were classified into 3 groups according to the CADILLAC risk score: low risk (n=176), intermediate risk (n=87), and high risk (n=124). Data on adverse events within 30 days after hospitalization, including in-hospital death, sustained ventricular arrhythmia, recurrent myocardial infarction, heart failure requiring intravenous treatment, stroke, or clinical hemorrhage, were collected.
Results
In the low risk group, adverse events within 30 days were significantly less observed, compared to the intermediate and high risk groups (n=13, 7.4% vs. n=13, 14.9% vs. n=58, 46.8%, p<0.001). In particular, all adverse events occurred within 3 days in the low risk group, although adverse events, such as heart failure (n=4), recurrent myocardial infarction (n=1), stroke (n=1), and gastrointestinal bleeding (n=1), were substantially observed after day 4 of hospitalization in the intermediate and high risk groups.
Conclusions
In STEMI patients with low CADILLAC risk score, better short-term prognosis was observed compared to the intermediate and high risk groups, and all adverse events occurred within 3 days of hospitalization, suggesting that discharge at day 4 might be safe in this study population. CADILLAC risk score may help stratify patient risk for short-term prognosis and adjust management of STEMI patients.
Initial event occurrence timing
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Satou
- Chiba University Hospital, Chiba, Japan
| | | | - K Ishikawa
- Eastern Chiba Medical Center, Cardiology, Chiba, Japan
| | | | | | - K Sano
- Eastern Chiba Medical Center, Cardiology, Chiba, Japan
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Santos-Gallego CG, Requena-Ibanez JA, San Antonio R, Garcia-Ropero A, Ishikawa K, Watanabe S, Picatoste B, Vargas-Delgado AP, Flores-Umanzor EJ, Sanz J, Fuster V, Badimon JJ. Empagliflozin Ameliorates Diastolic Dysfunction and Left Ventricular Fibrosis/Stiffness in Nondiabetic Heart Failure: A Multimodality Study. JACC Cardiovasc Imaging 2020; 14:393-407. [PMID: 33129742 DOI: 10.1016/j.jcmg.2020.07.042] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [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: 11/06/2019] [Revised: 07/08/2020] [Accepted: 07/31/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate the effect of empagliflozin on diastolic function in a nondiabetic heart failure with reduced ejection fraction (HFrEF) scenario and on the pathways causing diastolic dysfunction. BACKGROUND This group demonstrated that empagliflozin ameliorates adverse cardiac remodeling, enhances myocardial energetics, and improves left ventricular systolic function in a nondiabetic porcine model of HF. Whether empagliflozin also improves diastolic function remains unknown. Hypothetically, empagliflozin would improve diastolic function in HF mediated both by a reduction in interstitial myocardial fibrosis and an improvement in cardiomyocyte stiffness (titin phosphorylation). METHODS HF was induced in nondiabetic pigs by 2-h balloon occlusion of proximal left anterior descending artery. Animals were randomized to empagliflozin or placebo for 2 months. Cardiac function was evaluated with cardiac magnetic resonance (CMR), 3-dimensional echocardiography, and invasive hemodynamics. In vitro relaxation of cardiomyocytes was studied in primary culture. Myocardial samples were obtained for histological and molecular evaluation. Myocardial metabolite consumption was analyzed by simultaneous blood sampling from coronary artery and coronary sinus. RESULTS Despite similar initial ischemic myocardial injury, the empagliflozin group showed significantly improved diastolic function at 2 months, assessed by conventional echocardiography (higher e' and color M-mode propagation velocity, lower E/e' ratio, myocardial performance Tei index, isovolumic relaxation time, and left atrial size), echocardiography-derived strain imaging (strain imaging diastolic index, strain rate at isovolumic relaxation time and during early diastole, and untwisting), and CMR (higher peak filling rate, larger first filling volume). Invasive hemodynamics confirmed improved diastolic function with empagliflozin (better peak LV pressure rate of decay (-dP/dt), shorter Tau, lower end-diastolic pressure-volume relationship (EDPVR), and reduced filling pressures). Empagliflozin reduced interstitial myocardial fibrosis at the imaging, histological and molecular level. Empagliflozin improved nitric oxide signaling (endothelial nitric oxide synthetase [eNOS] activity, nitric oxide [NO] availability, cyclic guanosine monophosphate (cGMP) content, protein kinase G [PKG] signaling) and enhanced titin phosphorylation (which is responsible for cardiomyocyte stiffness). Indeed, isolated cardiomyocytes exhibited better relaxation in empagliflozin-treated animals. Myocardial consumption of glucose and ketone bodies negatively and positively correlated with diastolic function, respectively. CONCLUSIONS Empagliflozin ameliorates diastolic function in a nondiabetic HF porcine model, mitigates histological and molecular remodeling, and reduces both left ventricle and cardiomyocyte stiffness.
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Affiliation(s)
| | | | - Rodolfo San Antonio
- Department of Cardiology, Mount Sinai School of Medicine, New York, New York, USA
| | - Alvaro Garcia-Ropero
- Department of Cardiology, Mount Sinai School of Medicine, New York, New York, USA
| | - Kiyotake Ishikawa
- Department of Cardiology, Mount Sinai School of Medicine, New York, New York, USA
| | - Shin Watanabe
- Department of Cardiology, Mount Sinai School of Medicine, New York, New York, USA
| | - Belen Picatoste
- Department of Cardiology, Mount Sinai School of Medicine, New York, New York, USA
| | | | | | - Javier Sanz
- Department of Cardiology, Mount Sinai School of Medicine, New York, New York, USA
| | - Valentin Fuster
- Department of Cardiology, Mount Sinai School of Medicine, New York, New York, USA
| | - Juan J Badimon
- Department of Cardiology, Mount Sinai School of Medicine, New York, New York, USA.
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Nahrendorf M, Hoyer FF, Meerwaldt AE, van Leent MMT, Senders ML, Calcagno C, Robson PM, Soultanidis G, Pérez-Medina C, Teunissen AJP, Toner YC, Ishikawa K, Fish K, Sakurai K, van Leeuwen EM, Klein ED, Sofias AM, Reiner T, Rohde D, Aguirre AD, Wojtkiewicz G, Schmidt S, Iwamoto Y, Izquierdo-Garcia D, Caravan P, Swirski FK, Weissleder R, Mulder WJM. Imaging Cardiovascular and Lung Macrophages With the Positron Emission Tomography Sensor 64Cu-Macrin in Mice, Rabbits, and Pigs. Circ Cardiovasc Imaging 2020; 13:e010586. [PMID: 33076700 DOI: 10.1161/circimaging.120.010586] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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] [Indexed: 12/13/2022]
Abstract
BACKGROUND Macrophages, innate immune cells that reside in all organs, defend the host against infection and injury. In the heart and vasculature, inflammatory macrophages also enhance tissue damage and propel cardiovascular diseases. METHODS We here use in vivo positron emission tomography (PET) imaging, flow cytometry, and confocal microscopy to evaluate quantitative noninvasive assessment of cardiac, arterial, and pulmonary macrophages using the nanotracer 64Cu-Macrin-a 20-nm spherical dextran nanoparticle assembled from nontoxic polyglucose. RESULTS PET imaging using 64Cu-Macrin faithfully reported accumulation of macrophages in the heart and lung of mice with myocardial infarction, sepsis, or pneumonia. Flow cytometry and confocal microscopy detected the near-infrared fluorescent version of the nanoparticle (VT680Macrin) primarily in tissue macrophages. In 5-day-old mice, 64Cu-Macrin PET imaging quantified physiologically more numerous cardiac macrophages. Upon intravenous administration of 64Cu-Macrin in rabbits and pigs, we detected heightened macrophage numbers in the infarcted myocardium, inflamed lung regions, and atherosclerotic plaques using a clinical PET/magnetic resonance imaging scanner. Toxicity studies in rats and human dosimetry estimates suggest that 64Cu-Macrin is safe for use in humans. CONCLUSIONS Taken together, these results indicate 64Cu-Macrin could serve as a facile PET nanotracer to survey spatiotemporal macrophage dynamics during various physiological and pathological conditions. 64Cu-Macrin PET imaging could stage inflammatory cardiovascular disease activity, assist disease management, and serve as an imaging biomarker for emerging macrophage-targeted therapeutics.
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Affiliation(s)
- Matthias Nahrendorf
- Center for Systems Biology (M.N., F.F.H., D.R., A.D.A., G.W., S.S., Y.I., F.K.S., R.W.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston.,Department of Radiology (M.N., F.F.H., D.R., F.K.S., R.W.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston.,Cardiovascular Research Center (M.N., A.D.A.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston.,Department of Internal Medicine I, University Hospital Wuerzburg, Germany (M.N.)
| | - Friedrich Felix Hoyer
- Center for Systems Biology (M.N., F.F.H., D.R., A.D.A., G.W., S.S., Y.I., F.K.S., R.W.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston.,Department of Radiology (M.N., F.F.H., D.R., F.K.S., R.W.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston
| | - Anu E Meerwaldt
- Biomedical Engineering and Imaging Institute (A.E.M., M.M.T.v.L., M.L.S., C.C., P.M.R., G.S., C.P.-M., A.J.P.T., Y.C.T., K.S., E.M.v.L., E.D.K., A.M.S., W.J.M.M.), Icahn School of Medicine at Mount Sinai, New York, NY.,Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, the Netherlands (A.E.M., E.M.v.L.)
| | - Mandy M T van Leent
- Biomedical Engineering and Imaging Institute (A.E.M., M.M.T.v.L., M.L.S., C.C., P.M.R., G.S., C.P.-M., A.J.P.T., Y.C.T., K.S., E.M.v.L., E.D.K., A.M.S., W.J.M.M.), Icahn School of Medicine at Mount Sinai, New York, NY.,Department of Medical Biochemistry, Amsterdam University Medical Centers, University of Amsterdam, the Netherlands (M.M.T.v.L., M.L.S., W.J.M.M.)
| | - Max L Senders
- Biomedical Engineering and Imaging Institute (A.E.M., M.M.T.v.L., M.L.S., C.C., P.M.R., G.S., C.P.-M., A.J.P.T., Y.C.T., K.S., E.M.v.L., E.D.K., A.M.S., W.J.M.M.), Icahn School of Medicine at Mount Sinai, New York, NY.,Department of Medical Biochemistry, Amsterdam University Medical Centers, University of Amsterdam, the Netherlands (M.M.T.v.L., M.L.S., W.J.M.M.)
| | - Claudia Calcagno
- Biomedical Engineering and Imaging Institute (A.E.M., M.M.T.v.L., M.L.S., C.C., P.M.R., G.S., C.P.-M., A.J.P.T., Y.C.T., K.S., E.M.v.L., E.D.K., A.M.S., W.J.M.M.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Philip M Robson
- Biomedical Engineering and Imaging Institute (A.E.M., M.M.T.v.L., M.L.S., C.C., P.M.R., G.S., C.P.-M., A.J.P.T., Y.C.T., K.S., E.M.v.L., E.D.K., A.M.S., W.J.M.M.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - George Soultanidis
- Biomedical Engineering and Imaging Institute (A.E.M., M.M.T.v.L., M.L.S., C.C., P.M.R., G.S., C.P.-M., A.J.P.T., Y.C.T., K.S., E.M.v.L., E.D.K., A.M.S., W.J.M.M.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Carlos Pérez-Medina
- Biomedical Engineering and Imaging Institute (A.E.M., M.M.T.v.L., M.L.S., C.C., P.M.R., G.S., C.P.-M., A.J.P.T., Y.C.T., K.S., E.M.v.L., E.D.K., A.M.S., W.J.M.M.), Icahn School of Medicine at Mount Sinai, New York, NY.,Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (C.P.-M.)
| | - Abraham J P Teunissen
- Biomedical Engineering and Imaging Institute (A.E.M., M.M.T.v.L., M.L.S., C.C., P.M.R., G.S., C.P.-M., A.J.P.T., Y.C.T., K.S., E.M.v.L., E.D.K., A.M.S., W.J.M.M.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Yohana C Toner
- Biomedical Engineering and Imaging Institute (A.E.M., M.M.T.v.L., M.L.S., C.C., P.M.R., G.S., C.P.-M., A.J.P.T., Y.C.T., K.S., E.M.v.L., E.D.K., A.M.S., W.J.M.M.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kiyotake Ishikawa
- Department of Cardiology, Cardiovascular Research Center (K.I., K.F.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kenneth Fish
- Department of Cardiology, Cardiovascular Research Center (K.I., K.F.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ken Sakurai
- Biomedical Engineering and Imaging Institute (A.E.M., M.M.T.v.L., M.L.S., C.C., P.M.R., G.S., C.P.-M., A.J.P.T., Y.C.T., K.S., E.M.v.L., E.D.K., A.M.S., W.J.M.M.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Esther M van Leeuwen
- Biomedical Engineering and Imaging Institute (A.E.M., M.M.T.v.L., M.L.S., C.C., P.M.R., G.S., C.P.-M., A.J.P.T., Y.C.T., K.S., E.M.v.L., E.D.K., A.M.S., W.J.M.M.), Icahn School of Medicine at Mount Sinai, New York, NY.,Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, the Netherlands (A.E.M., E.M.v.L.)
| | - Emma D Klein
- Biomedical Engineering and Imaging Institute (A.E.M., M.M.T.v.L., M.L.S., C.C., P.M.R., G.S., C.P.-M., A.J.P.T., Y.C.T., K.S., E.M.v.L., E.D.K., A.M.S., W.J.M.M.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Alexandros Marios Sofias
- Biomedical Engineering and Imaging Institute (A.E.M., M.M.T.v.L., M.L.S., C.C., P.M.R., G.S., C.P.-M., A.J.P.T., Y.C.T., K.S., E.M.v.L., E.D.K., A.M.S., W.J.M.M.), Icahn School of Medicine at Mount Sinai, New York, NY.,Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (A.M.S.)
| | - Thomas Reiner
- Department of Radiology and Chemical Biology Program, Memorial Sloan- Kettering Cancer Center, New York, NY (T.R.).,Department of Radiology, Weill Cornell Medical College, New York, NY (T.R.)
| | - David Rohde
- Center for Systems Biology (M.N., F.F.H., D.R., A.D.A., G.W., S.S., Y.I., F.K.S., R.W.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston.,Department of Radiology (M.N., F.F.H., D.R., F.K.S., R.W.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston
| | - Aaron D Aguirre
- Center for Systems Biology (M.N., F.F.H., D.R., A.D.A., G.W., S.S., Y.I., F.K.S., R.W.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston.,Cardiovascular Research Center (M.N., A.D.A.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston.,Wellman Center for Photomedicine (A.D.A.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston
| | - Gregory Wojtkiewicz
- Center for Systems Biology (M.N., F.F.H., D.R., A.D.A., G.W., S.S., Y.I., F.K.S., R.W.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston
| | - Stephen Schmidt
- Center for Systems Biology (M.N., F.F.H., D.R., A.D.A., G.W., S.S., Y.I., F.K.S., R.W.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston
| | - Yoshiko Iwamoto
- Center for Systems Biology (M.N., F.F.H., D.R., A.D.A., G.W., S.S., Y.I., F.K.S., R.W.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston
| | - David Izquierdo-Garcia
- Institute for Innovation in Imaging, A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown (D.I.-G., P.C., R.W.)
| | - Peter Caravan
- Institute for Innovation in Imaging, A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown (D.I.-G., P.C., R.W.)
| | - Filip K Swirski
- Center for Systems Biology (M.N., F.F.H., D.R., A.D.A., G.W., S.S., Y.I., F.K.S., R.W.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston.,Department of Radiology (M.N., F.F.H., D.R., F.K.S., R.W.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston
| | - Ralph Weissleder
- Center for Systems Biology (M.N., F.F.H., D.R., A.D.A., G.W., S.S., Y.I., F.K.S., R.W.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston.,Department of Radiology (M.N., F.F.H., D.R., F.K.S., R.W.), Massachusetts General Hospital Research Institute and Harvard Medical School, Boston.,Institute for Innovation in Imaging, A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown (D.I.-G., P.C., R.W.).,Department of Systems Biology, Harvard Medical School, Boston, MA (R.W.)
| | - Willem J M Mulder
- Biomedical Engineering and Imaging Institute (A.E.M., M.M.T.v.L., M.L.S., C.C., P.M.R., G.S., C.P.-M., A.J.P.T., Y.C.T., K.S., E.M.v.L., E.D.K., A.M.S., W.J.M.M.), Icahn School of Medicine at Mount Sinai, New York, NY.,Department of Oncological Sciences (W.J.M.M.), Icahn School of Medicine at Mount Sinai, New York, NY.,Department of Medical Biochemistry, Amsterdam University Medical Centers, University of Amsterdam, the Netherlands (M.M.T.v.L., M.L.S., W.J.M.M.).,Laboratory of Chemical Biology, Department of Biomedical Engineering and Institute for Complex Molecular Systems, Eindhoven University of Technology, the Netherlands (W.J.M.M.)
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Kariya T, Yamada KP, Bikou O, Tharakan S, Miyashita S, Ishikawa K. Novel Porcine Model of Coronary Dissection Reveals the Impact of Impella on Dissected Coronary Arterial Hemodynamics. Front Cardiovasc Med 2020; 7:162. [PMID: 33110912 PMCID: PMC7522595 DOI: 10.3389/fcvm.2020.00162] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/05/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Coronary artery dissection (CAD) sometimes accompanies unstable hemodynamics and requires mechanical cardiac support. Meanwhile, mechanical cardiac support may influence coronary hemodynamics in CAD. No study has examined the impact of Impella left ventricular (LV) support on CAD. Materials and Methods: CAD was induced in eight Yorkshire pigs by injuring the left anterior descending artery (LAD) using a 0.018-in. stiff guidewire and/or deep engagement of a blunt-cut coronary guiding catheter. After the creation of CAD, hemodynamic parameters, coronary pressure, and flow as well as coronary angiograms were acquired before and after maximum LV support using the Impella CP. Result: CADs with a large flap were successfully created by deep engagement of a blunt-tip guiding catheter with forceful contrast injection. One animal (#8) exhibited thrombolysis in myocardial infarction (TIMI)-1 flow, while the others (animals #1-#7) showed TIMI-2/3 flow. In TIMI-2/3 animals, maximal Impella support increased mean coronary pressure (108.4 ± 22.5 to 124.7 ± 28.0 mmHg, P < 0.001) with unchanged mean coronary flow velocity (63.50 ± 28.66 to 48.32 ± 13.30 cm/s, P = 0.17) of the LAD distal to the dissection. The LV end-diastolic pressure (20.6 ± 6.6 vs. 12.0 ± 3.4 mmHg, P = 0.032), LV end-diastolic volume (127 ± 32 vs. 97 ± 26 ml, P = 0.015), stroke volume (68 ± 16 vs. 48 ± 14 ml, P = 0.003), stroke work (5,744 ± 1,866 vs. 4,424 ± 1,650 mmHg·ml, P = 0.003), and heart rate (71.4 ± 6.6 vs. 64.9 ± 9.3/min, P = 0.014) were all significantly reduced by Impella support, indicating effective unloading of the LV. In the TIMI-1 animal (animal #8), maximal Impella support resulted in further delay in angiographic coronary flow and reduced distal coronary pressure (22.9-17.1 mmHg), together with increased false-lumen pressure. Conclusion: Impella support effectively unloaded the LV and maintained the hemodynamics in a novel porcine model of CAD. Coronary pressure distal to the dissection was increased in TIMI-2/3 animals after Impella support but decreased in the animal with initial TIMI-1 flow.
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Affiliation(s)
| | | | | | | | | | - Kiyotake Ishikawa
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Rodriguez P, Sassi Y, Troncone L, Benard L, Ishikawa K, Gordon RE, Lamas S, Laborda J, Hajjar RJ, Lebeche D. Deletion of delta-like 1 homologue accelerates fibroblast-myofibroblast differentiation and induces myocardial fibrosis. Eur Heart J 2020; 40:967-978. [PMID: 29668883 DOI: 10.1093/eurheartj/ehy188] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [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: 11/09/2017] [Revised: 02/14/2018] [Accepted: 03/21/2018] [Indexed: 12/11/2022] Open
Abstract
AIMS Myocardial fibrosis is associated with profound changes in ventricular architecture and geometry, resulting in diminished cardiac function. There is currently no information on the role of the delta-like homologue 1 (Dlk1) in the regulation of the fibrotic response. Here, we investigated whether Dlk1 is involved in cardiac fibroblast-to-myofibroblast differentiation and regulates myocardial fibrosis and explored the molecular mechanism underpinning its effects in this process. METHODS AND RESULTS Using Dlk1-knockout mice and adenoviral gene delivery, we demonstrate that overexpression of Dlk1 in cardio-fibroblasts resulted in inhibition of fibroblast proliferation and differentiation into myofibroblasts. This process is mediated by TGF-β1 signalling, since isolated fibroblasts lacking Dlk1 exhibited a higher activation of the TGF-β1/Smad-3 pathway at baseline, leading to an earlier acquisition of a myofibroblast phenotype. Likewise, Dlk1-null mice displayed increased TGF-β1/Smad3 cardiac activity, resulting in infiltration/accumulation of myofibroblasts, induction and deposition of extra-domain A-fibronectin isoform and collagen, and activation of pro-fibrotic markers. Furthermore, these profibrotic events were associated with disrupted myofibril integrity, myocyte hypertrophy, and cardiac dysfunction. Interestingly, Dlk1 expression was down-regulated in ischaemic human and porcine heart tissues. Mechanistically, miR-370 mediated Dlk1's regulation of cardiac fibroblast-myofibroblast differentiation by directly targeting TGFβ-R2/Smad-3 signalling, while the Dlk1 canonical target, Notch pathway, does not seem to play a role in this process. CONCLUSION These findings are the first to demonstrate an inhibitory role of Dlk1 of cardiac fibroblast-to-myofibroblast differentiation by interfering with TGFβ/Smad-3 signalling in the myocardium. Given the deleterious effects of continuous activation of this pathway, we propose Dlk1 as a new potential candidate for therapy in cases where aberrant TGFβ signalling leads to chronic fibrosis.
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Affiliation(s)
| | - Yassine Sassi
- Department of Medicine, Cardiovascular Research Institute
| | - Luca Troncone
- Department of Medicine, Cardiovascular Research Institute
| | - Ludovic Benard
- Department of Medicine, Cardiovascular Research Institute
| | | | - Ronald E Gordon
- Department of Pathology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, USA
| | - Santiago Lamas
- Centro de Biología Molecular 'Severo Ochoa' (CSIC-UAM), Nicolás Cabrera 1, Campus UAM, Madrid, Spain
| | - Jorge Laborda
- Department of Inorganic and Organic Chemistry and Biochemistry, Pharmacy School/Biomedical Unit/CRIB, University of Castilla-La Mancha/CSIC, Dr. José María Sánchez Ibáñez Street, s/n Albacete, Spain
| | - Roger J Hajjar
- Department of Medicine, Cardiovascular Research Institute
| | - Djamel Lebeche
- Department of Medicine, Cardiovascular Research Institute
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Abstract
Advancements in conventional cardiac care have significantly reduced mortality from coronary heart disease and acute myocardial infarction. However, the prevalence of heart failure continues to increase in an aging population with profound social and economic consequences. Cardiac gene therapy with adeno-associated virus (AAV) vectors is emerging as a potential modality for addressing this desperate clinical need. After showing initial promise in extensive preclinical studies and an early clinical trial, disappointing results of large-scale clinical trial derailed the progress of AAV-mediated cardiac gene therapy. However, it appears that knowledge gained from previous failures coupled with developments in targeted gene delivery have set the stage for a new frontier in cardiac AAV gene therapy.
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Affiliation(s)
- Kelly P Yamada
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Serena Tharakan
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kiyotake Ishikawa
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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