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Mitchell MI, Ben‐Dov IZ, Ye K, Liu C, Shi M, Sadoughi A, Shah C, Siddiqui T, Okorozo A, Gutierrez M, Unawane R, Biamonte L, Parihk K, Spivack S, Loudig O. Exhaled breath condensate contains extracellular vesicles (EVs) that carry miRNA cargos of lung tissue origin that can be selectively purified and analyzed. J Extracell Vesicles 2024; 13:e12440. [PMID: 38659349 PMCID: PMC11043690 DOI: 10.1002/jev2.12440] [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: 09/27/2023] [Accepted: 03/24/2024] [Indexed: 04/26/2024] Open
Abstract
Lung diseases, including lung cancer, are rising causes of global mortality. Despite novel imaging technologies and the development of biomarker assays, the detection of lung cancer remains a significant challenge. However, the lung communicates directly with the external environment and releases aerosolized droplets during normal tidal respiration, which can be collected, stored and analzsed as exhaled breath condensate (EBC). A few studies have suggested that EBC contains extracellular vesicles (EVs) whose microRNA (miRNA) cargos may be useful for evaluating different lung conditions, but the cellular origin of these EVs remains unknown. In this study, we used nanoparticle tracking, transmission electron microscopy, Western blot analyses and super resolution nanoimaging (ONi) to detect and validate the identity of exhaled EVs (exh-EVs). Using our customizable antibody-purification assay, EV-CATCHER, we initially determined that exh-EVs can be selectively enriched from EBC using antibodies against three tetraspanins (CD9, CD63 and CD81). Using ONi we also revealed that some exh-EVs harbour lung-specific proteins expressed in bronchiolar Clara cells (Clara Cell Secretory Protein [CCSP]) and Alveolar Type II cells (Surfactant protein C [SFTPC]). When conducting miRNA next generation sequencing (NGS) of airway samples collected at five different anatomic levels (i.e., mouth rinse, mouth wash, bronchial brush, bronchoalveolar lavage [BAL] and EBC) from 18 subjects, we determined that miRNA profiles of exh-EVs clustered closely to those of BAL EVs but not to those of other airway samples. When comparing the miRNA profiles of EVs purified from matched BAL and EBC samples with our three tetraspanins EV-CATCHER assay, we captured significant miRNA expression differences associated with smoking, asthma and lung tumor status of our subjects, which were also reproducibly detected in EVs selectively purified with our anti-CCSP/SFTPC EV-CATCHER assay from the same samples, but that confirmed their lung tissue origin. Our findings underscore that enriching exh-EV subpopulations from EBC allows non-invasive sampling of EVs produced by lung tissues.
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Affiliation(s)
- Megan I. Mitchell
- Center for Discovery and InnovationHackensack Meridian HealthNutleyNew JerseyUSA
| | - Iddo Z. Ben‐Dov
- Laboratory of Medical Transcriptomics, Internal Medicine BHadassah‐Hebrew University Medical CenterJerusalemIsrael
| | - Kenny Ye
- The Albert Einstein College of MedicineMontefiore Medical CenterBronxNew JerseyUSA
| | - Christina Liu
- Center for Discovery and InnovationHackensack Meridian HealthNutleyNew JerseyUSA
| | - Miao Shi
- The Albert Einstein College of MedicineMontefiore Medical CenterBronxNew JerseyUSA
| | - Ali Sadoughi
- The Albert Einstein College of MedicineMontefiore Medical CenterBronxNew JerseyUSA
| | - Chirag Shah
- The Albert Einstein College of MedicineMontefiore Medical CenterBronxNew JerseyUSA
| | - Taha Siddiqui
- The Albert Einstein College of MedicineMontefiore Medical CenterBronxNew JerseyUSA
| | - Aham Okorozo
- The Albert Einstein College of MedicineMontefiore Medical CenterBronxNew JerseyUSA
| | - Martin Gutierrez
- Department of Thoracic OncologyHackensack University Medical Center, Hackensack Meridian HealthHackensackNew JerseyUSA
| | - Rashmi Unawane
- Department of Thoracic OncologyHackensack University Medical Center, Hackensack Meridian HealthHackensackNew JerseyUSA
| | - Lisa Biamonte
- Department of Thoracic OncologyHackensack University Medical Center, Hackensack Meridian HealthHackensackNew JerseyUSA
| | - Kaushal Parihk
- Department of Thoracic OncologyThe Mayo ClinicRochesterMinnesotaUSA
| | - Simon Spivack
- The Albert Einstein College of MedicineMontefiore Medical CenterBronxNew JerseyUSA
| | - Olivier Loudig
- Center for Discovery and InnovationHackensack Meridian HealthNutleyNew JerseyUSA
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Katsumata Y, Fardo DW, Shade LMP, Wu X, Karanth SD, Hohman TJ, Schneider JA, Bennett DA, Farfel JM, Gauthreaux K, Mock C, Kukull WA, Abner EL, Nelson PT. Genetic associations with dementia-related proteinopathy: Application of item response theory. Alzheimers Dement 2024; 20:2906-2921. [PMID: 38460116 PMCID: PMC11032554 DOI: 10.1002/alz.13741] [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: 07/07/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 03/11/2024]
Abstract
INTRODUCTION Although dementia-related proteinopathy has a strong negative impact on public health, and is highly heritable, understanding of the related genetic architecture is incomplete. METHODS We applied multidimensional generalized partial credit modeling (GPCM) to test genetic associations with dementia-related proteinopathies. Data were analyzed to identify candidate single nucleotide variants for the following proteinopathies: Aβ, tau, α-synuclein, and TDP-43. RESULTS Final included data comprised 966 participants with neuropathologic and WGS data. Three continuous latent outcomes were constructed, corresponding to TDP-43-, Aβ/Tau-, and α-synuclein-related neuropathology endophenotype scores. This approach helped validate known genotype/phenotype associations: for example, TMEM106B and GRN were risk alleles for TDP-43 pathology; and GBA for α-synuclein/Lewy bodies. Novel suggestive proteinopathy-linked alleles were also discovered, including several (SDHAF1, TMEM68, and ARHGEF28) with colocalization analyses and/or high degrees of biologic credibility. DISCUSSION A novel methodology using GPCM enabled insights into gene candidates for driving misfolded proteinopathies. HIGHLIGHTS Latent factor scores for proteinopathies were estimated using a generalized partial credit model. The three latent continuous scores corresponded well with proteinopathy severity. Novel genes associated with proteinopathies were identified. Several genes had high degrees of biologic credibility for dementia risk factors.
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Affiliation(s)
- Yuriko Katsumata
- Department of BiostatisticsUniversity of KentuckyLexingtonKentuckyUSA
- Sanders‐Brown Center on AgingUniversity of KentuckyLexingtonKentuckyUSA
| | - David W. Fardo
- Department of BiostatisticsUniversity of KentuckyLexingtonKentuckyUSA
- Sanders‐Brown Center on AgingUniversity of KentuckyLexingtonKentuckyUSA
| | | | - Xian Wu
- Department of BiostatisticsUniversity of KentuckyLexingtonKentuckyUSA
- Sanders‐Brown Center on AgingUniversity of KentuckyLexingtonKentuckyUSA
| | - Shama D. Karanth
- Department of SurgeryCollege of MedicineUniversity of FloridaGainesvilleFloridaUSA
- UF Health Cancer CenterUniversity of FloridaGainesvilleFloridaUSA
| | - Timothy J. Hohman
- Vanderbilt Memory and Alzheimer's CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Julie A. Schneider
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
- Department of PathologyRush University Medical CenterChicagoIllinoisUSA
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - David A. Bennett
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
- Department of PathologyRush University Medical CenterChicagoIllinoisUSA
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Jose M. Farfel
- Department of PathologyRush University Medical CenterChicagoIllinoisUSA
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Kathryn Gauthreaux
- National Alzheimer's Coordinating CenterDepartment of EpidemiologyUniversity of WashingtonSeattleWashingtonUSA
| | - Charles Mock
- National Alzheimer's Coordinating CenterDepartment of EpidemiologyUniversity of WashingtonSeattleWashingtonUSA
| | - Walter A. Kukull
- National Alzheimer's Coordinating CenterDepartment of EpidemiologyUniversity of WashingtonSeattleWashingtonUSA
| | - Erin L. Abner
- Sanders‐Brown Center on AgingUniversity of KentuckyLexingtonKentuckyUSA
- Department of Epidemiology and Environmental HealthUniversity of KentuckyLexingtonKentuckyUSA
| | - Peter T. Nelson
- Sanders‐Brown Center on AgingUniversity of KentuckyLexingtonKentuckyUSA
- Department of PathologyDivision of NeuropathologyUniversity of KentuckyLexingtonKentuckyUSA
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Massengale K, Barnes VA, Williams C, Mansuri A, Norland K, Altvater M, Bailey H, Harris RA, Su S, Wang X. Nocturnal blood pressure dipping, blood pressure variability, and cognitive function in early and middle-aged adults. J Clin Hypertens (Greenwich) 2024; 26:235-240. [PMID: 38332546 PMCID: PMC10918738 DOI: 10.1111/jch.14764] [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: 11/01/2023] [Revised: 11/28/2023] [Accepted: 12/03/2023] [Indexed: 02/10/2024]
Abstract
Higher nighttime blood pressure (BP), less BP dipping, and higher BP variability have been linked with worse cognitive function in the elderly. The goal of this study is to explore whether this relationship already exists in early and middle adulthood. We further examined whether ethnic differences between African Americans and European Americans in BP parameters can explain ethnic differences in cognitive function. 24-h ambulatory BP monitoring and cognitive function were obtained from 390 participants (average age: 37.2 years with a range of 25-50; 54.9% African Americans; 63.6% females). We observed that higher nighttime BP, decreased dipping, and higher variability were significantly associated with lower scores on the Picture Sequence Memory Test. Significant negative associations between variability and overall composite scores were also observed. No significant associations between average 24-h or daytime BP and cognitive function were observed. Ethnic differences in nighttime diastolic pressures and dipping can explain 6.81% to 10.8% of the ethnicity difference in the score of the Picture Sequence Memory Test (ps < .05). This study suggests that the associations of nighttime BP, dipping, and variability with cognitive function already exist in young and middle-aged adults. Ethnic differences in nighttime BP and dipping can at least partially explain ethnic differences in cognitive function. The stronger association of these parameters with cognitive function than daytime or average BP in this age range raises the importance of using ambulatory BP monitoring for more precise detection of abnormal BP patterns in young adulthood.
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Affiliation(s)
| | - Vernon A. Barnes
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Celestin Williams
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Asifhusen Mansuri
- Division of Pediatric Nephrology and HypertensionChildren's Hospital of GeorgiaMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Kimberly Norland
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Michelle Altvater
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Hallie Bailey
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Ryan A. Harris
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Shaoyong Su
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Xiaoling Wang
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
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Guduguntla BA, Vasbinder A, Anderson E, Azam TU, Blakely P, Webster NJ, Gonzalez R, Atonucci T, Heidebrink JL, Giordani B, Zahodne L, Hampstead BM, Ajrouch KJ, Hayek SS. Biomarkers of chronic inflammation and cognitive decline: A prospective observational study. Alzheimers Dement (Amst) 2024; 16:e12568. [PMID: 38532827 PMCID: PMC10964918 DOI: 10.1002/dad2.12568] [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] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 03/28/2024]
Abstract
We sought to determine whether the biomarkers of chronic inflammation predict cognitive decline in a prospective observational study. We measured baseline serum soluble urokinase plasminogen activator receptor (suPAR) and high sensitivity C-reactive protein (hs-CRP) levels in 282 participants of the University of Michigan Memory and Aging Project. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA) and the Clinical Dementia Rating (CDR) scale for up to five time points. SuPAR and hs-CRP levels were not significantly higher in participants with mild cognitive impairment (n = 97) or dementia (n = 59), compared to those with normal cognitive function (n = 126). Overall, 14% of participants experienced significant cognitive decline over the study period. The change in MoCA or CDR scores over time did not differ significantly according to baseline suPAR or hs-CRP levels. Chronic systemic inflammation, as measured by serum suPAR or hs-CRP levels, is unlikely to contribute significantly to cognitive decline.
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Affiliation(s)
| | - Alexi Vasbinder
- Division of CardiologyDepartment of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Elizabeth Anderson
- Division of CardiologyDepartment of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Tariq U. Azam
- Division of CardiologyDepartment of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Pennelope Blakely
- Division of CardiologyDepartment of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Noah J. Webster
- Institute for Social ResearchUniversity of MichiganAnn ArborMichiganUSA
| | - Richard Gonzalez
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | - Toni Atonucci
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | | | - Bruno Giordani
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
- Department of NeurologyUniversity of MichiganAnn ArborMichiganUSA
- Department of PsychiatryUniversity of MichiganAnn ArborMichiganUSA
| | - Laura Zahodne
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | - Benjamin M. Hampstead
- Department of PsychiatryUniversity of MichiganAnn ArborMichiganUSA
- Mental Health Service Line, Veterans Affairs Ann Arbor Healthcare SystemAnn ArborMichiganUSA
| | - Kristine J. Ajrouch
- Institute for Social ResearchUniversity of MichiganAnn ArborMichiganUSA
- Eastern Michigan UniversityYpsilantiMichiganUSA
| | - Salim S. Hayek
- Division of CardiologyDepartment of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
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Nikmaneshi MR, Baish JW, Zhou H, Padera TP, Munn LL. Transport Barriers Influence the Activation of Anti-Tumor Immunity: A Systems Biology Analysis. Adv Sci (Weinh) 2023; 10:e2304076. [PMID: 37949675 PMCID: PMC10754116 DOI: 10.1002/advs.202304076] [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] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/07/2023] [Indexed: 11/12/2023]
Abstract
Effective anti-cancer immune responses require activation of one or more naïve T cells. If the correct naïve T cell encounters its cognate antigen presented by an antigen presenting cell, then the T cell can activate and proliferate. Here, mathematical modeling is used to explore the possibility that immune activation in lymph nodes is a rate-limiting step in anti-cancer immunity and can affect response rates to immune checkpoint therapy. The model provides a mechanistic framework for optimizing cancer immunotherapy and developing testable solutions to unleash anti-tumor immune responses for more patients with cancer. The results show that antigen production rate and trafficking of naïve T cells into the lymph nodes are key parameters and that treatments designed to enhance tumor antigen production can improve immune checkpoint therapies. The model underscores the potential of radiation therapy in augmenting tumor immunogenicity and neoantigen production for improved ICB therapy, while emphasizing the need for careful consideration in cases where antigen levels are already sufficient to avoid compromising the immune response.
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Affiliation(s)
- Mohammad R. Nikmaneshi
- Department of Radiation OncologyMassachusetts General Hospital and Harvard Medical SchoolBostonMA02114USA
| | - James W. Baish
- Biomedical EngineeringBucknell UniversityLewisburgPA17837USA
| | - Hengbo Zhou
- Department of Radiation OncologyMassachusetts General Hospital and Harvard Medical SchoolBostonMA02114USA
| | - Timothy P. Padera
- Department of Radiation OncologyMassachusetts General Hospital and Harvard Medical SchoolBostonMA02114USA
| | - Lance L. Munn
- Department of Radiation OncologyMassachusetts General Hospital and Harvard Medical SchoolBostonMA02114USA
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Snoke DB, Bellefleur E, Rehman HT, Carson JA, Poynter ME, Dittus KL, Toth MJ. Skeletal muscle adaptations in patients with lung cancer: Longitudinal observations from the whole body to cellular level. J Cachexia Sarcopenia Muscle 2023; 14:2579-2590. [PMID: 37727010 PMCID: PMC10751417 DOI: 10.1002/jcsm.13332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 08/02/2023] [Accepted: 08/21/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Cancer and its treatment can adversely affect skeletal muscle, impacting physical function, treatment response and survival. No studies, however, have comprehensively characterized these muscle adaptations longitudinally in human patients at the cellular level. METHODS We examined skeletal muscle size and function from the whole body to the sub-cellular level in 11 patients with non-small cell lung cancer (NSCLC; 6 male/5 female, mean age 58 ± 3 years) studied over a 2-month observation period starting during their first cycle of standard of care cancer treatment and in 11 age- and sex-matched healthy controls (HC) without a current or past history of cancer. Biopsies of the vastus lateralis were performed to assess muscle fibre size, contractility and mitochondrial content, along with assessments of physical function, whole muscle size and function, and circulating cytokines. RESULTS Body weight, composition and thigh muscle area and density were unaltered over time in patients with NSCLC, while muscle density was lower in patients with NSCLC versus HC (P = 0.03). Skeletal muscle fibre size decreased by 18% over time in patients (all P = 0.02) and was lower than HC (P = 0.02). Mitochondrial fractional area and density did not change over time in patients, but fractional area was lower in patients with NSCLC compared with HC (subsarcolemmal, P = 0.04; intermyofibrillar, P = 0.03). Patients with NSCLC had higher plasma concentrations of IL-6 (HC 1.40 ± 0.50; NSCLC 4.71 ± 4.22; P < 0.01), GDF-15 (HC 569 ± 166; NSCLC 2071 ± 1168; P < 0.01) and IL-8/CXCL8 (HC 4.9 ± 1.8; NSCLC 10.1 ± 6.0; P = 0.02) compared with HC, but there were no changes in inflammatory markers in patients with NSCLC over time. No changes were observed in markers of satellite cell activation or DNA damage in patients and no group differences were noted with HC. Whole-muscle strength was preserved over time in patients with NSCLC coincident with improved single fibre contractility. CONCLUSIONS This study is the first to comprehensively examine longitudinal alterations in skeletal muscle fibre size and function in patients with NSCLC and suggests that muscle fibre atrophy occurs during cancer treatment despite weight stability and no changes in conventional clinical measurements of whole body or thigh muscle size over this period.
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Affiliation(s)
- Deena B. Snoke
- Department of MedicineUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Emma Bellefleur
- Department of MedicineUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Hibba Tul Rehman
- Department of MedicineUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
- University of Vermont Cancer CenterUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - James A. Carson
- Department of Physical TherapyThe University of Tennessee Health Science CenterMemphisTennesseeUSA
| | - Matthew E. Poynter
- Department of MedicineUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Kim L. Dittus
- Department of MedicineUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
- University of Vermont Cancer CenterUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Michael J. Toth
- Department of MedicineUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
- University of Vermont Cancer CenterUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
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Dimagli A, Spadaccio C, Myers A, Demetres M, Rademaker‐Havinga T, Stone GW, Spertus JA, Redfors B, Fremes S, Gaudino M, Masterson Creber R. Quality of Life After Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting. J Am Heart Assoc 2023; 12:e030069. [PMID: 37982221 PMCID: PMC10727273 DOI: 10.1161/jaha.123.030069] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/06/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Differences in quality of life (QoL) after coronary artery bypass grafting (CABG) compared with percutaneous coronary intervention (PCI) are not well characterized. We aimed to compare the short- and long-term effects of CABG versus PCI on QoL. METHODS AND RESULTS We performed a systematic review and meta-analysis of randomized controlled trials comparing CABG versus PCI using the Seattle Angina Questionnaire (SAQ)-Angina Frequency, SAQ-QoL, SAQ-Physical Limitations, EuroQoL-5D, and Short-Form Questionnaire. We calculated mean changes within each group from baseline to 1, 6, 12, and 36 to 60 months (latest follow-up) and the weighted mean differences between groups using inverse-variance methods. A total of 10 760 patients were enrolled in 5 trials. From baseline to 12 months and 36 to 60 months, the mean change in SAQ-Angina Frequency was >22 points (95% CI, 21.0-25.6) after both PCI and CABG. The mean difference in SAQ-Angina Frequency was similar between procedures at 1 month and at 36 to 60 months but favored CABG at 12 months (1.97 [95% CI, 0.68-3.26]). SAQ-QoL favored PCI at 1 month (-2.92 [95% CI, -4.66 to -1.18]) and CABG at 6 (2.50 [95% CI, 1.02-3.97]), 12 (3.30 [95% CI, 1.78-4.82]), and 36 to 60 months (3.17 [95% CI, 0.54 5.80). SAQ-Physical Limitations (-12.61 [95% CI, -16.16 to -9.06]) and EuroQoL-5D (-0.07 [95% CI, -0.08 to -0.07) favored PCI at 1 month. Short-Form Questionnaire-Physical Component favored CABG at 12 months (1.18 [95% CI, 0.46-1.90]). CONCLUSIONS Both PCI and CABG improved long-term disease-specific and generic QoL.
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Affiliation(s)
- Arnaldo Dimagli
- Bristol Heart Institute, University of BristolBristolUnited Kingdom
- Department of Cardiothoracic SurgeryWeill Cornell Medical CollegeNew YorkNY
| | | | - Annie Myers
- Columbia University Irving Medical CenterNew YorkNY
| | - Michelle Demetres
- Department of Cardiothoracic SurgeryWeill Cornell Medical CollegeNew YorkNY
| | | | - Gregg W. Stone
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount SinaiNew YorkNY
| | - John A. Spertus
- Saint Luke’s Mid America Heart Institute, University of MissouriKansas CityMO
| | | | - Stephen Fremes
- Sunnybrook Health Sciences CenterUniversity of TorontoTorontoCanada
| | - Mario Gaudino
- Department of Cardiothoracic SurgeryWeill Cornell Medical CollegeNew YorkNY
| | - Ruth Masterson Creber
- Columbia University School of NursingColumbia University Irving Medical CenterNew YorkNY
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Wallace AS, Ogungbe O, Sattler ELP, Aidoo E, Allen TS, Bernard L, Chen Y, Du S, Formagini T, Gaye B, King B, Kwon S, Larbi Kwapong F, Liu T, Makarem N, Mendez‐Rodriguez H, Metlock FE, Moukaled S, Nichols AR, Ozkan B, Trivedi R, Turkson‐Ocran R, Wang FM, Wang C, Xu Y, Yin CY, Zhang M, Alonso A, Hivert M. Highlights From the American Heart Association's EPI|Lifestyle Scientific Sessions 2023. J Am Heart Assoc 2023; 12:e029894. [PMID: 37804204 PMCID: PMC10757524 DOI: 10.1161/jaha.123.029894] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/18/2023] [Indexed: 10/09/2023]
Affiliation(s)
- Amelia S. Wallace
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
- Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins UniversityBaltimoreMDUSA
| | | | - Elisabeth L. P. Sattler
- Department of Clinical and Administrative Pharmacy, College of PharmacyUniversity of GeorgiaAthensGAUSA
- Department of Nutritional Sciences, College of Family and Consumer SciencesUniversity of GeorgiaAthensGAUSA
| | - Emily Aidoo
- Department of General Medicine, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA
| | - Tara S. Allen
- Division of Preventive Medicine, Department of Family MedicineUniversity of California, San DiegoSan DiegoCAUSA
| | - Lauren Bernard
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
- Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins UniversityBaltimoreMDUSA
| | - Yingan Chen
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
- Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins UniversityBaltimoreMDUSA
| | - Shutong Du
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
- Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins UniversityBaltimoreMDUSA
| | - Taynara Formagini
- Department of Family Medicine and Public HealthUniversity of California San DiegoSan DiegoCAUSA
- Institute for Behavioral & Community HealthSan Diego State UniversitySan DiegoCAUSA
| | - Bamba Gaye
- Department of EpidemiologyINSERM, U970, Paris Cardiovascular Research CenterParisFrance
- Paris Cardiovascular Research CentreUniversité de Paris, INSERMParisFrance
| | - Ben King
- Tilman J Fertitta Family College of Medicine, Department of Health Systems and Population Health SciencesUniversity of HoustonHoustonTXUSA
- Humana Integrated Health Systems Sciences InstituteUniversity of HoustonHoustonTXUSA
| | - Sohyeon Kwon
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
- Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins UniversityBaltimoreMDUSA
| | - Fredrick Larbi Kwapong
- Department of General Medicine, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA
| | - Tiange Liu
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - Nour Makarem
- Department of Epidemiology, Mailman School of Public HealthColumbia University Irving Medical CenterNew YorkNYUSA
| | - Heidy Mendez‐Rodriguez
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical PsychologySan DiegoCAUSA
| | | | - Shirine Moukaled
- Department of EpidemiologyTulane University School of Public Health and Tropical MedicineNew OrleansLAUSA
| | - Amy R. Nichols
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMAUSA
- Department of Population MedicineHarvard Medical SchoolBostonMAUSA
- Harvard Pilgrim Health Care InstituteBostonMAUSA
| | - Bige Ozkan
- Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins UniversityBaltimoreMDUSA
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of CardiologyJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - Rupal Trivedi
- Department of Clinical and Administrative Pharmacy, College of PharmacyUniversity of GeorgiaAthensGAUSA
| | - Ruth‐Alma Turkson‐Ocran
- Department of General Medicine, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA
| | - Frances M. Wang
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
- Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins UniversityBaltimoreMDUSA
| | - Caroline Wang
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
- Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins UniversityBaltimoreMDUSA
| | - Yunwen Xu
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - Christina Y. Yin
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - Mingyu Zhang
- Department of Population MedicineHarvard Medical SchoolBostonMAUSA
- Harvard Pilgrim Health Care InstituteBostonMAUSA
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public HealthEmory UniversityAtlantaGAUSA
| | - Marie‐France Hivert
- Department of Population MedicineHarvard Medical SchoolBostonMAUSA
- Harvard Pilgrim Health Care InstituteBostonMAUSA
- Diabetes UnitMassachusetts General HospitalBostonMAUSA
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Besser LM, Lovasi GS, Zambrano JJ, Camacho S, Dhanekula D, Michael YL, Garg P, Hirsch JA, Siscovick D, Hurvitz PM, Biggs ML, Galvin JE, Bartz TM, Longstreth WT. Neighborhood greenspace and neighborhood income associated with white matter grade worsening: Cardiovascular Health Study. Alzheimers Dement (Amst) 2023; 15:e12484. [PMID: 37885920 PMCID: PMC10598801 DOI: 10.1002/dad2.12484] [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] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/28/2023] [Accepted: 09/11/2023] [Indexed: 10/28/2023]
Abstract
INTRODUCTION We examined whether a combined measure of neighborhood greenspace and neighborhood median income was associated with white matter hyperintensity (WMH) and ventricle size changes. METHODS The sample included 1260 cognitively normal ≥ 65-year-olds with two magnetic resonance images (MRI; ≈ 5 years apart). WMH and ventricular size were graded from 0 (least) to 9 (most) abnormal (worsening = increase of ≥1 grade from initial to follow-up MRI scans). The four-category neighborhood greenspace-income measure was based on median neighborhood greenspace and income values at initial MRI. Multivariable logistic regression tested associations between neighborhood greenspace-income and MRI measures (worsening vs. not). RESULTS White matter grade worsening was more likely for those in lower greenspace-lower income neighborhoods than higher greenspace-higher income neighborhoods (odds ratio = 1.73; 95% confidence interval = 1.19-2.51). DISCUSSION The combination of lower neighborhood income and lower greenspace may be a risk factor for worsening white matter grade on MRI. However, findings need to be replicated in more diverse cohorts. HIGHLIGHTS Population-based cohort of older adults (≥ 65 years) with greenspace and MRI dataCombined measure of neighborhood greenspace and neighborhood income at initial MRIMRI outcomes included white matter hyperintensities (WMH) and ventricular sizeLongitudinal change in MRI outcomes measured approximately 5 years apartWorsening WMH over time more likely for lower greenspace-lower income neighborhoods.
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Affiliation(s)
- Lilah M. Besser
- Comprehensive Center for Brain HealthDepartment of NeurologyUniversity of Miami Miller School of MedicineBoca RatonFloridaUSA
| | - Gina S. Lovasi
- Urban Health Collaborative and Department of Epidemiology and BiostatisticsDornslife School of Public HealthDrexel UniversityPhiladelphiaPennsylvaniaUSA
| | - Joyce Jimenez Zambrano
- Comprehensive Center for Brain HealthDepartment of NeurologyUniversity of Miami Miller School of MedicineBoca RatonFloridaUSA
| | - Simone Camacho
- Comprehensive Center for Brain HealthDepartment of NeurologyUniversity of Miami Miller School of MedicineBoca RatonFloridaUSA
| | | | - Yvonne L. Michael
- Urban Health Collaborative and Department of Epidemiology and BiostatisticsDornslife School of Public HealthDrexel UniversityPhiladelphiaPennsylvaniaUSA
| | - Parveen Garg
- Division of CardiologyKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Jana A. Hirsch
- Urban Health Collaborative and Department of Epidemiology and BiostatisticsDornslife School of Public HealthDrexel UniversityPhiladelphiaPennsylvaniaUSA
| | - David Siscovick
- Division of ResearchEvaluation, and PolicyThe New York Academy of MedicineNew YorkNew YorkUSA
| | - Philip M. Hurvitz
- Center for Studies in Demography and Ecology and Urban Form LabUniversity of WashingtonSeattleWashingtonUSA
| | - Mary L. Biggs
- Department of BiostatisticsSchool of Public HealthUniversity of WashingtonSeattleWashingtonUSA
| | - James E. Galvin
- Comprehensive Center for Brain HealthDepartment of NeurologyMiller School of MedicineUniversity of MiamiMiamiFloridaUSA
| | - Traci M. Bartz
- Department of BiostatisticsUniversity of WashingtonSeattleWashingtonUSA
| | - W. T. Longstreth
- Departments of Neurology and EpidemiologyUniversity of WashingtonSeattleWashingtonUSA
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10
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Han JH, Jackson JC, Orun OM, Brown SM, Casey JD, Clark L, Collins SP, Cordero K, Ginde AA, Gong MN, Hough CL, Iwashyna TJ, Kiehl AL, Lauck A, Leither LM, Lindsell CJ, Patel MB, Raman R, Rice TW, Ringwood NJ, Sheppard KL, Semler MW, Thompson BT, Ely EW, Self WH. Modifiable in-hospital factors for 12-month global cognition, post-traumatic stress disorder symptoms, and depression symptoms in adults hospitalized with COVID-19. Influenza Other Respir Viruses 2023; 17:e13197. [PMID: 37752063 PMCID: PMC10522479 DOI: 10.1111/irv.13197] [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: 11/03/2022] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND We sought to identify potentially modifiable in-hospital factors associated with global cognition, post-traumatic stress disorder (PTSD) symptoms, and depression symptoms at 12 months. METHODS This was a multi-center prospective cohort study in adult hospitalized patients with acute COVID-19. The following in-hospital factors were assessed: delirium; frequency of in-person and virtual visits by friends and family; and hydroxychloroquine, corticosteroid, and remdesivir administration. Twelve-month global cognition was characterized by the MOCA-Blind. Twelve-month PTSD and depression were characterized using the PTSD Checklist for the DSM-V and Hospital Anxiety Depression Scale, respectively. FINDINGS Two hundred three patients completed the 12-month follow-up assessments. Remdesivir use was associated with significantly higher cognition at 12 months based on the MOCA-Blind (adjusted odds ratio [aOR] = 1.98, 95% CI: 1.06, 3.70). Delirium was associated with worsening 12-month PTSD (aOR = 3.44, 95% CI: 1.89, 6.28) and depression (aOR = 2.18, 95% CI: 1.23, 3.84) symptoms. Multiple virtual visits per day during hospitalization was associated with lower 12-month depression symptoms compared to those with less than daily virtual visits (aOR = 0.40, 95% CI: 0.19, 0.85). CONCLUSION Potentially modifiable factors associated with better long-term outcomes included remdesivir use (associated with better cognitive function), avoidance of delirium (associated with less PTSD and depression symptoms), and increased virtual interactions with friends and family (associated with less depression symptoms).
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Affiliation(s)
- Jin H. Han
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Geriatric Research, Education, and Clinical Center (GRECC)Tennessee Valley Healthcare SystemNashvilleTennesseeUSA
- Department of Emergency MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - James C. Jackson
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Geriatric Research, Education, and Clinical Center (GRECC)Tennessee Valley Healthcare SystemNashvilleTennesseeUSA
- Division of Allergy, Pulmonary, and Critical Care, Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Onur M. Orun
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of BiostatisticsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Samuel M. Brown
- Division of Pulmonary/Critical Care Medicine, Department of MedicineIntermountain Medical Center and the University of UtahSalt Lake CityUtahUSA
| | - Jonathan D. Casey
- Division of Allergy, Pulmonary, and Critical Care, Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Lindsay Clark
- Division of Geriatrics and GerontologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Geriatric Research, Education, and Clinical Center (GRECC)William S Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Sean P. Collins
- Geriatric Research, Education, and Clinical Center (GRECC)Tennessee Valley Healthcare SystemNashvilleTennesseeUSA
- Department of Emergency MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Kemberlyne Cordero
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Adit A. Ginde
- Department of Emergency MedicineUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Michelle N. Gong
- Division of Critical Care, Division of Pulmonary Medicine, Department of MedicineAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Catherine L. Hough
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of MedicineOregon Health & Science UniversityPortlandOregonUSA
| | - Theodore J. Iwashyna
- Division of Pulmonary and Critical Care, Department of MedicineJohns Hopkins UniversityBaltimoreMarylandUSA
- Health Policy & Management in the Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Amy L. Kiehl
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Alana Lauck
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Lindsay M. Leither
- Division of Pulmonary/Critical Care Medicine, Department of MedicineIntermountain Medical Center and the University of UtahSalt Lake CityUtahUSA
| | | | - Mayur B. Patel
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Geriatric Research, Education, and Clinical Center (GRECC)Tennessee Valley Healthcare SystemNashvilleTennesseeUSA
- Division of Acute Care Surgery, Department of Surgery, Section of Surgical SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Rameela Raman
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of BiostatisticsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Todd W. Rice
- Division of Allergy, Pulmonary, and Critical Care, Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
- Vanderbilt Institute for Clinical and Translational Research (VICTR)Vanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Nancy J. Ringwood
- Division of Pulmonary and Critical Care MedicineMassachusetts General HospitalBostonMassachusettsUSA
| | - Karen L. Sheppard
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Matthew W. Semler
- Division of Allergy, Pulmonary, and Critical Care, Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - B. Taylor Thompson
- Division of Pulmonary and Critical Care MedicineMassachusetts General HospitalBostonMassachusettsUSA
| | - E. Wesley Ely
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Geriatric Research, Education, and Clinical Center (GRECC)Tennessee Valley Healthcare SystemNashvilleTennesseeUSA
- Division of Allergy, Pulmonary, and Critical Care, Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Wesley H. Self
- Department of Emergency MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
- Division of Acute Care Surgery, Department of Surgery, Section of Surgical SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
- Vanderbilt Institute for Clinical and Translational Research (VICTR)Vanderbilt University Medical CenterNashvilleTennesseeUSA
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11
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Bruder‐Nascimento A, Awata WMC, Alves JV, Singh S, Costa RM, Bruder‐Nascimento T. Progranulin Maintains Blood Pressure and Vascular Tone Dependent on EphrinA2 and Sortilin1 Receptors and Endothelial Nitric Oxide Synthase Activation. J Am Heart Assoc 2023; 12:e030353. [PMID: 37581395 PMCID: PMC10492929 DOI: 10.1161/jaha.123.030353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/06/2023] [Indexed: 08/16/2023]
Abstract
Background The mechanisms determining vascular tone are still not completely understood, even though it is a significant factor in blood pressure management. Many circulating proteins have a significant impact on controlling vascular tone. Progranulin displays anti-inflammatory effects and has been extensively studied in neurodegenerative illnesses. We investigated whether progranulin sustains the vascular tone that helps regulate blood pressure. Methods and Results We used male and female C57BL6/J wild type (progranulin+/+) and B6(Cg)-Grntm1.1Aidi/J (progranulin-/-) to understand the impact of progranulin on vascular contractility and blood pressure. We found that progranulin-/- mice display elevated blood pressure followed by hypercontractility to noradrenaline in mesenteric arteries, which is restored by supplementing the mice with recombinant progranulin. In ex vivo experiments, recombinant progranulin attenuated the vascular contractility to noradrenaline in male and female progranulin+/+ arteries, which was blunted by blocking EphrinA2 or Sortilin1. To understand the mechanisms whereby progranulin evokes anticontractile effects, we inhibited endothelial factors. N(gamma)-nitro-L-arginine methyl ester (nitric oxide synthase inhibitor) prevented the progranulin effects, whereas indomethacin (cyclooxygenase inhibitor) affected only the contractility in arteries incubated with vehicle, indicating that progranulin increases nitric oxide and decreases contractile prostanoids. Finally, recombinant progranulin induced endothelial nitric oxide synthase phosphorylation and nitric oxide production in isolated mesenteric endothelial cells. Conclusions Circulating progranulin regulates vascular tone and blood pressure via EphrinA2 and Sortilin1 receptors and endothelial nitric oxide synthase activation. Collectively, our data suggest that deficiency in progranulin is a cardiovascular risk factor and that progranulin might be a new therapeutic avenue to treat high blood pressure.
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Affiliation(s)
- Ariane Bruder‐Nascimento
- Department of PediatricsUniversity of PittsburghPittsburghPAUSA
- Center for Pediatrics Research in Obesity and Metabolism (CPROM)PittsburghPAUSA
| | - Wanessa M. C. Awata
- Department of PediatricsUniversity of PittsburghPittsburghPAUSA
- Center for Pediatrics Research in Obesity and Metabolism (CPROM)PittsburghPAUSA
| | - Juliano V. Alves
- Department of PediatricsUniversity of PittsburghPittsburghPAUSA
- Center for Pediatrics Research in Obesity and Metabolism (CPROM)PittsburghPAUSA
| | - Shubhnita Singh
- Department of PediatricsUniversity of PittsburghPittsburghPAUSA
- Center for Pediatrics Research in Obesity and Metabolism (CPROM)PittsburghPAUSA
| | - Rafael M. Costa
- Department of PediatricsUniversity of PittsburghPittsburghPAUSA
- Center for Pediatrics Research in Obesity and Metabolism (CPROM)PittsburghPAUSA
| | - Thiago Bruder‐Nascimento
- Department of PediatricsUniversity of PittsburghPittsburghPAUSA
- Center for Pediatrics Research in Obesity and Metabolism (CPROM)PittsburghPAUSA
- Endocrinology Division at UPMC Children’s Hospital of PittsburghPittsburghPAUSA
- Vascular Medicine Institute (VMI), University of PittsburghPittsburghPAUSA
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12
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Ahn HW, Worman ZF, Lechsinska A, Payer LM, Wang T, Malik N, Li W, Burns KH, Nath A, Levin HL. Retrotransposon insertions associated with risk of neurologic and psychiatric diseases. EMBO Rep 2023; 24:e55197. [PMID: 36367221 PMCID: PMC9827563 DOI: 10.15252/embr.202255197] [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: 04/08/2022] [Revised: 10/11/2022] [Accepted: 10/20/2022] [Indexed: 11/13/2022] Open
Abstract
Transposable elements (TEs) are active in neuronal cells raising the question whether TE insertions contribute to risk of neuropsychiatric disease. While genome-wide association studies (GWAS) serve as a tool to discover genetic loci associated with neuropsychiatric diseases, unfortunately GWAS do not directly detect structural variants such as TEs. To examine the role of TEs in psychiatric and neurologic disease, we evaluated 17,000 polymorphic TEs and find 76 are in linkage disequilibrium with disease haplotypes (P < 10-6 ) defined by GWAS. From these 76 polymorphic TEs, we identify potentially causal candidates based on having insertions in genomic regions of regulatory chromatin and on having associations with altered gene expression in brain tissues. We show that lead candidate insertions have regulatory effects on gene expression in human neural stem cells altering the activity of a minimal promoter. Taken together, we identify 10 polymorphic TE insertions that are potential candidates on par with other variants for having a causal role in neurologic and psychiatric disorders.
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Affiliation(s)
- Hyo Won Ahn
- Division of Molecular and Cellular BiologyEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of HealthBethesdaMDUSA
| | - Zelia F Worman
- Division of Molecular and Cellular BiologyEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of HealthBethesdaMDUSA
- Present address:
Seven BridgesCharlestownMAUSA
| | - Arianna Lechsinska
- Division of Molecular and Cellular BiologyEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of HealthBethesdaMDUSA
| | - Lindsay M Payer
- Department of PathologyJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - Tongguang Wang
- Translational Neuroscience CenterNational Institute of Neurological Disorders and Stroke, National Institutes of HealthBethesdaMDUSA
| | - Nasir Malik
- Translational Neuroscience CenterNational Institute of Neurological Disorders and Stroke, National Institutes of HealthBethesdaMDUSA
| | - Wenxue Li
- Section of Infections of the Nervous SystemNational Institute of Neurological Disorders and Stroke, National Institutes of HealthBethesdaMDUSA
| | - Kathleen H Burns
- Department of Oncologic PathologyDana‐Farber Cancer InstituteBostonMAUSA
| | - Avindra Nath
- Translational Neuroscience CenterNational Institute of Neurological Disorders and Stroke, National Institutes of HealthBethesdaMDUSA
- Section of Infections of the Nervous SystemNational Institute of Neurological Disorders and Stroke, National Institutes of HealthBethesdaMDUSA
| | - Henry L Levin
- Division of Molecular and Cellular BiologyEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of HealthBethesdaMDUSA
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13
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Hagen MW, Louey S, Alaniz SM, Belcik T, Muller MM, Brown L, Lindner JR, Jonker SS. Changes in microvascular perfusion of heart and skeletal muscle in sheep around the time of birth. Exp Physiol 2023; 108:135-145. [PMID: 36420621 PMCID: PMC9805518 DOI: 10.1113/ep090809] [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: 08/29/2022] [Accepted: 11/04/2022] [Indexed: 11/25/2022]
Abstract
NEW FINDINGS What is the central question of this study? How does the microvascular perfusion of striated muscle change during the dynamic developmental period between the late gestation fetus and early neonate? What is the main finding and its importance? In both myocardium and skeletal muscle, perfusion of striated muscle is significantly reduced in the neonate compared to the late term fetus, but flow reserve is unchanged. The results suggest striated muscle capillary networks grow more slowly relative to the myofibres they nourish during the perinatal period. ABSTRACT Microvascular perfusion of striated muscle is an important determinant of health throughout life. Birth is a transition with profound effects on the growth and function of striated muscle, but the regulation of microvascular perfusion around this transition is poorly understood. We used contrast-enhanced ultrasound perfusion imaging (CEUS) to study the perfusion of left ventricular myocardium and hindlimb biceps femoris, which are populations of muscle with different degrees of change in pre- to postnatal workloads and different capacities for postnatal proliferative growth. We studied separate groups of lambs in late gestation (135 days' gestational age; 92% of term) and shortly after birth (5 days' postnatal age). We used CEUS to quantify baseline perfusion, perfusion during hyperaemia induced by adenosine infusion (myocardium) or electrically stimulated unloaded exercise (skeletal muscle), flow reserve and oxygen delivery. We found heart-to-body weight ratio was greater in neonates than fetuses. Microvascular volume and overall perfusion were lower in neonates than fetuses in both muscle groups at baseline and with hyperaemia. Flux rate differed with muscle group, with myocardial flux being faster in neonates than fetuses, but skeletal muscle flux being slower. Oxygen delivery to skeletal muscle at baseline was lower in neonates than fetuses, but was not significantly different in myocardium. Flow reserve was not different between ages. Given the significant somatic growth, and the transition from hyperplastic to hypertrophic myocyte growth occurring in the perinatal period, we postulate that the primary driver of lower neonatal striated muscle perfusion is faster growth of myofibres than their associated capillary networks.
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Affiliation(s)
- Matthew W. Hagen
- Center for Developmental HealthOregon Health & Science UniversityPortlandORUSA
- Knight Cardiovascular InstituteOregon Health & Science UniversityPortlandORUSA
| | - Samantha Louey
- Center for Developmental HealthOregon Health & Science UniversityPortlandORUSA
- Knight Cardiovascular InstituteOregon Health & Science UniversityPortlandORUSA
| | - Sarah M. Alaniz
- Center for Developmental HealthOregon Health & Science UniversityPortlandORUSA
| | - Todd Belcik
- Knight Cardiovascular InstituteOregon Health & Science UniversityPortlandORUSA
| | - Matthew M. Muller
- Knight Cardiovascular InstituteOregon Health & Science UniversityPortlandORUSA
| | - Laura Brown
- Department of PediatricsUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Jonathan R. Lindner
- Knight Cardiovascular InstituteOregon Health & Science UniversityPortlandORUSA
- Division of Cardiovascular MedicineUniversity of Virginia Medical CenterCharlottesvilleVAUSA
| | - Sonnet S. Jonker
- Center for Developmental HealthOregon Health & Science UniversityPortlandORUSA
- Knight Cardiovascular InstituteOregon Health & Science UniversityPortlandORUSA
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14
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Selamet Tierney ES, Chung S, Stauffer KJ, Brabender J, Collins RT, Folk R, Li W, Murthy AK, Murphy DJ, Esfandiarei M. Can 10 000 Healthy Steps a Day Slow Aortic Root Dilation in Pediatric Patients With Marfan Syndrome? J Am Heart Assoc 2022; 11:e027598. [PMID: 36453629 PMCID: PMC9851465 DOI: 10.1161/jaha.122.027598] [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: 12/03/2022]
Abstract
Background Stiffer aortas are associated with a faster rate of aortic root (AoR) dilation and higher risk of aortic dissection in patients with Marfan syndrome. We have previously shown that mild aerobic exercise reduces aortic stiffness and rate of AoR dilation in a Marfan mouse model. In this study, we investigated if these results could be translated to pediatric patients with Marfan syndrome. Methods and Results We enrolled 24 patients with Marfan syndrome aged 8 to 19 years to participate in a 6-month physical activity intervention, excluding those with ventricular dysfunction or prior history of aortic surgery. We instructed patients to take 10 000 steps per day, tracked by an activity tracker. At baseline and 6 months, we measured AoR dimension, arterial stiffness, endothelial function, physical activity indices, inflammatory biomarkers, and coping scores. Controls consisted of 15 age-matched patients with Marfan syndrome. Twenty-four patients with Marfan syndrome (median age, 14.4 years [interquartile range {IQR}, 12.2-16.8], 14 male patients) were enrolled. Baseline assessment demonstrated that the majority of these patients were sedentary and had abnormal arterial health. Twenty-two patients completed the intervention and took an average of 7709±2177 steps per day (median, 7627 [IQR, 6344-9671]). Patients wore their Garmin trackers at a median of 92.8% (IQR, 84%-97%) of their intervention days. AoR Z score in the intervention group had a significantly lower rate of change per year compared with the controls (rate of change, -0.24 versus +0.008; P=0.01). Conclusions In this clinical intervention in pediatric patients with Marfan syndrome, we demonstrated that a simple physical activity intervention was feasible in this population and has the potential to decrease the AoR dilation rate. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT03567460.
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Affiliation(s)
- Elif Seda Selamet Tierney
- Division of Pediatric Cardiology, Department of PediatricsStanford University Medical CenterPalo AltoCA
| | - Sukyung Chung
- Division of Pediatric Cardiology, Department of PediatricsStanford University Medical CenterPalo AltoCA
| | - Katie Jo Stauffer
- Division of Pediatric Cardiology, Department of PediatricsStanford University Medical CenterPalo AltoCA
| | - Jerrid Brabender
- Division of Pediatric Cardiology, Department of PediatricsStanford University Medical CenterPalo AltoCA
| | - Ronnie Thomad Collins
- Division of Pediatric Cardiology, Department of PediatricsStanford University Medical CenterPalo AltoCA
| | - Robert Folk
- Biomedical Sciences Program, Midwestern UniversityGlendaleAZ
| | - Weidang Li
- College of Veterinary MedicineMidwestern UniversityGlendaleAZ
| | | | - Daniel Jerome Murphy
- Division of Pediatric Cardiology, Department of PediatricsStanford University Medical CenterPalo AltoCA
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15
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Bortoletto AS, Graham WV, Trout G, Bonito‐Oliva A, Kazmi MA, Gong J, Weyburne E, Houser BL, Sakmar TP, Parchem RJ. Human Islet Amyloid Polypeptide (hIAPP) Protofibril-Specific Antibodies for Detection and Treatment of Type 2 Diabetes. Adv Sci (Weinh) 2022; 9:e2202342. [PMID: 36257905 PMCID: PMC9731688 DOI: 10.1002/advs.202202342] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/26/2022] [Indexed: 05/27/2023]
Abstract
Type 2 diabetes mellitus (T2D) is a major public health concern and is characterized by sustained hyperglycemia due to insulin resistance and destruction of insulin-producing β cells. One pathological hallmark of T2D is the toxic accumulation of human islet amyloid polypeptide (hIAPP) aggregates. Monomeric hIAPP is a hormone normally co-secreted with insulin. However, increased levels of hIAPP in prediabetic and diabetic patients can lead to the formation of hIAPP protofibrils, which are toxic to β cells. Current therapies fail to address hIAPP aggregation and current screening modalities do not detect it. Using a stabilizing capping protein, monoclonal antibodies (mAbs) can be developed against a previously nonisolatable form of hIAPP protofibrils, which are protofibril specific and do not engage monomeric hIAPP. Shown here are two candidate mAbs that can detect hIAPP protofibrils in serum and hIAPP deposits in pancreatic islets in a mouse model of rapidly progressing T2D. Treatment of diabetic mice with the mAbs delays disease progression and dramatically increases overall survival. These results demonstrate the potential for using novel hIAPP protofibril-specific mAbs as a diagnostic screening tool for early detection of T2D, as well as therapeutically to preserve β cell function and target one of the underlying pathological mechanisms of T2D.
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Affiliation(s)
- Angelina S. Bortoletto
- Center for Cell and Gene TherapyStem Cells and Regenerative Medicine CenterDepartment of NeuroscienceDepartment of Molecular and Cellular BiologyTranslational Biology and Molecular Medicine ProgramMedical Scientist Training ProgramBaylor College of MedicineOne Baylor PlazaHoustonTX77030USA
| | - W. Vallen Graham
- Laboratory of Chemical Biology & Signal TransductionThe Rockefeller University1230 York AvenueNew YorkNY10065USA
| | - Gabriella Trout
- Center for Cell and Gene TherapyStem Cells and Regenerative Medicine CenterDepartment of NeuroscienceDepartment of Molecular and Cellular BiologyTranslational Biology and Molecular Medicine ProgramMedical Scientist Training ProgramBaylor College of MedicineOne Baylor PlazaHoustonTX77030USA
| | - Alessandra Bonito‐Oliva
- Laboratory of Chemical Biology & Signal TransductionThe Rockefeller University1230 York AvenueNew YorkNY10065USA
| | - Manija A. Kazmi
- Laboratory of Chemical Biology & Signal TransductionThe Rockefeller University1230 York AvenueNew YorkNY10065USA
| | - Jing Gong
- Celdara Medical16 Cavendish CourtLebanonNH03766USA
| | | | | | - Thomas P. Sakmar
- Laboratory of Chemical Biology & Signal TransductionThe Rockefeller University1230 York AvenueNew YorkNY10065USA
- Department of Neurobiology, Care Sciences, and SocietyCenter for Alzheimer ResearchDivision of NeurogeriatricsKarolinska InstitutetSolna17164Sweden
| | - Ronald J. Parchem
- Center for Cell and Gene TherapyStem Cells and Regenerative Medicine CenterDepartment of NeuroscienceDepartment of Molecular and Cellular BiologyTranslational Biology and Molecular Medicine ProgramMedical Scientist Training ProgramBaylor College of MedicineOne Baylor PlazaHoustonTX77030USA
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16
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Ramos‐Cejudo J, Johnson AD, Beiser A, Seshadri S, Salinas J, Berger JS, Fillmore NR, Do N, Zheng C, Kovbasyuk Z, Ardekani BA, Pomara N, Bubu OM, Parekh A, Convit A, Betensky RA, Wisniewski TM, Osorio RS. Platelet Function Is Associated With Dementia Risk in the Framingham Heart Study. J Am Heart Assoc 2022; 11:e023918. [PMID: 35470685 PMCID: PMC9238609 DOI: 10.1161/jaha.121.023918] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 02/01/2022] [Indexed: 12/15/2022]
Abstract
Background Vascular function is compromised in Alzheimer disease (AD) years before amyloid and tau pathology are detected and a substantial body of work shows abnormal platelet activation states in patients with AD. The aim of our study was to investigate whether platelet function in middle age is independently associated with future risk of AD. Methods and Results We examined associations of baseline platelet function with incident dementia risk in the community-based FHS (Framingham Heart Study) longitudinal cohorts. The association between platelet function and risk of dementia was evaluated using the cumulative incidence function and inverse probability weighted Cox proportional cause-specific hazards regression models, with adjustment for demographic and clinical covariates. Platelet aggregation response was measured by light transmission aggregometry. The final study sample included 1847 FHS participants (average age, 53.0 years; 57.5% women). During follow-up (median, 20.5 years), we observed 154 cases of incident dementia, of which 121 were AD cases. Results from weighted models indicated that platelet aggregation response to adenosine diphosphate 1.0 µmol/L was independently and positively associated with dementia risk, and it was preceded in importance only by age and hypertension. Sensitivity analyses showed associations with the same directionality for participants defined as adenosine diphosphate hyper-responders, as well as the platelet response to 0.1 µmol/L epinephrine. Conclusions Our study shows individuals free of antiplatelet therapy with a higher platelet response are at higher risk of dementia in late life during a 20-year follow-up, reinforcing the role of platelet function in AD risk. This suggests that platelet phenotypes may be associated with the rate of dementia and potentially have prognostic value.
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Affiliation(s)
- Jaime Ramos‐Cejudo
- Department of PsychiatryNew York University (NYU) Grossman School of MedicineNew YorkNY
- VA Boston Cooperative Studies ProgramMAVERICVA Boston Healthcare SystemBostonMA
| | - Andrew D. Johnson
- Population Sciences BranchDivision of Intramural ResearchNational Heart, Lung, and Blood InstituteFraminghamMA
- The Framingham StudyBostonMA
| | - Alexa Beiser
- The Framingham StudyBostonMA
- Department of BiostatisticsBoston University School of Public HealthBostonMA
- Department of NeurologyBoston University School of MedicineBostonMA
| | - Sudha Seshadri
- The Framingham StudyBostonMA
- Department of NeurologyBoston University School of MedicineBostonMA
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative DiseasesUniversity of Texas Health Sciences CenterSan AntonioTX
| | - Joel Salinas
- The Framingham StudyBostonMA
- Department of NeurologyCenter for Cognitive NeurologyNYU Grossman School of MedicineNew YorkNY
| | - Jeffrey S. Berger
- Division of Vascular SurgeryDepartment of SurgeryNYU Grossman School of MedicineNew YorkNY
- Divisions of Cardiology and HematologyDepartment MedicineNYU Grossman School of MedicineNew YorkNY
- Center for the Prevention of Cardiovascular DiseaseNYU Grossman School of MedicineNew YorkNY
| | - Nathanael R. Fillmore
- VA Boston Cooperative Studies ProgramMAVERICVA Boston Healthcare SystemBostonMA
- Harvard Medical SchoolBostonMA
| | - Nhan Do
- VA Boston Cooperative Studies ProgramMAVERICVA Boston Healthcare SystemBostonMA
- Boston University School of MedicineBostonMA
| | - Chunlei Zheng
- VA Boston Cooperative Studies ProgramMAVERICVA Boston Healthcare SystemBostonMA
- Boston University School of MedicineBostonMA
| | - Zanetta Kovbasyuk
- Department of PsychiatryNew York University (NYU) Grossman School of MedicineNew YorkNY
| | - Babak A. Ardekani
- Department of PsychiatryNew York University (NYU) Grossman School of MedicineNew YorkNY
- Nathan Kline InstituteOrangeburgNY
| | - Nunzio Pomara
- Department of PsychiatryNew York University (NYU) Grossman School of MedicineNew YorkNY
- Nathan Kline InstituteOrangeburgNY
| | - Omonigho M. Bubu
- Department of PsychiatryNew York University (NYU) Grossman School of MedicineNew YorkNY
| | - Ankit Parekh
- Division of PulmonaryCritical Care, and Sleep MedicineIcahn School of Medicine at Mount SinaiNew YorkNY
| | - Antonio Convit
- Department of PsychiatryNew York University (NYU) Grossman School of MedicineNew YorkNY
- Nathan Kline InstituteOrangeburgNY
| | - Rebecca A. Betensky
- Department of BiostatisticsNew York University School of Global Public HealthNew YorkNY
| | - Thomas M. Wisniewski
- Department of PsychiatryNew York University (NYU) Grossman School of MedicineNew YorkNY
- Department of NeurologyCenter for Cognitive NeurologyNYU Grossman School of MedicineNew YorkNY
- Department of PathologyNYU Grossman School of MedicineNew YorkNY
| | - Ricardo S. Osorio
- Department of PsychiatryNew York University (NYU) Grossman School of MedicineNew YorkNY
- Nathan Kline InstituteOrangeburgNY
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Park SH, Kim RS, Stiles WR, Jo M, Zeng L, Rho S, Baek Y, Kim J, Kim MS, Kang H, Choi HS. Injectable Thermosensitive Hydrogels for a Sustained Release of Iron Nanochelators. Adv Sci (Weinh) 2022; 9:e2200872. [PMID: 35343104 PMCID: PMC9130884 DOI: 10.1002/advs.202200872] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Indexed: 05/17/2023]
Abstract
Deferoxamine (DFO) is an FDA-approved iron-chelating agent which shows good therapeutic efficacy, however, its short blood half-life presents challenges such as the need for repeated injections or continuous infusions. Considering the lifelong need of chelating agents for iron overload patients, a sustained-release formulation that can reduce the number of chelator administrations is essential. Here, injectable hydrogel formulations prepared by integrating crosslinked hyaluronic acid into Pluronic F127 for an extended release of DFO nanochelators are reported. The subcutaneously injected hydrogel shows a thermosensitive sol-gel transition at physiological body temperature and provides a prolonged release of renal clearable nanochelators over 2 weeks, resulting in a half-life 47-fold longer than that of the nanochelator alone. In addition, no chronic toxicity of the nanochelator-loaded hydrogel is confirmed by biochemical and histological analyses. This injectable hydrogel formulation with DFO nanochelators has the potential to be a promising formulation for the treatment of iron overload disorders.
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Affiliation(s)
- Seung Hun Park
- Gordon Center for Medical ImagingDepartment of RadiologyMassachusetts General Hospital and Harvard Medical SchoolBostonMA02114USA
- Department of Molecular Science and TechnologyAjou UniversitySuwon16499South Korea
| | - Richard S. Kim
- Gordon Center for Medical ImagingDepartment of RadiologyMassachusetts General Hospital and Harvard Medical SchoolBostonMA02114USA
| | - Wesley R. Stiles
- Gordon Center for Medical ImagingDepartment of RadiologyMassachusetts General Hospital and Harvard Medical SchoolBostonMA02114USA
| | - Minjoo Jo
- Gordon Center for Medical ImagingDepartment of RadiologyMassachusetts General Hospital and Harvard Medical SchoolBostonMA02114USA
| | - Lingxue Zeng
- Department of Biomedical & Nutritional SciencesZuckerberg College of Health SciencesUniversity of MassachusettsLowellMA01854USA
| | - Sunghoon Rho
- Gordon Center for Medical ImagingDepartment of RadiologyMassachusetts General Hospital and Harvard Medical SchoolBostonMA02114USA
| | - Yoonji Baek
- Gordon Center for Medical ImagingDepartment of RadiologyMassachusetts General Hospital and Harvard Medical SchoolBostonMA02114USA
| | - Jonghan Kim
- Department of Biomedical & Nutritional SciencesZuckerberg College of Health SciencesUniversity of MassachusettsLowellMA01854USA
| | - Moon Suk Kim
- Department of Molecular Science and TechnologyAjou UniversitySuwon16499South Korea
| | - Homan Kang
- Gordon Center for Medical ImagingDepartment of RadiologyMassachusetts General Hospital and Harvard Medical SchoolBostonMA02114USA
| | - Hak Soo Choi
- Gordon Center for Medical ImagingDepartment of RadiologyMassachusetts General Hospital and Harvard Medical SchoolBostonMA02114USA
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18
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Zhang X, Farrell JJ, Tong T, Hu J, Zhu C, Wang L, Mayeux R, Haines JL, Pericak‐Vance MA, Schellenberg GD, Lunetta KL, Farrer LA. Association of mitochondrial variants and haplogroups identified by whole exome sequencing with Alzheimer's disease. Alzheimers Dement 2022; 18:294-306. [PMID: 34152079 PMCID: PMC8764625 DOI: 10.1002/alz.12396] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 07/31/2020] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Findings regarding the association between mitochondrial DNA (mtDNA) variants and Alzheimer's disease (AD) are inconsistent. METHODS We developed a pipeline for accurate assembly and variant calling in mitochondrial genomes embedded within whole exome sequences (WES) from 10,831 participants from the Alzheimer's Disease Sequencing Project (ADSP). Association of AD risk was evaluated with each mtDNA variant and variants located in 1158 nuclear genes related to mitochondrial function using the SCORE test. Gene-based tests were performed using SKAT-O. RESULTS Analysis of 4220 mtDNA variants revealed study-wide significant association of AD with a rare MT-ND4L variant (rs28709356 C>T; minor allele frequency = 0.002; P = 7.3 × 10-5 ) as well as with MT-ND4L in a gene-based test (P = 6.71 × 10-5 ). Significant association was also observed with a MT-related nuclear gene, TAMM41, in a gene-based test (P = 2.7 × 10-5 ). The expression of TAMM41 was lower in AD cases than controls (P = .00046) or mild cognitive impairment cases (P = .03). DISCUSSION Significant findings in MT-ND4L and TAMM41 provide evidence for a role of mitochondria in AD.
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Affiliation(s)
- Xiaoling Zhang
- Department of Medicine (Biomedical Genetics)Boston University School of Medicine72 East Concord StreetBostonMassachusetts02118USA
- Department of BiostatisticsBoston University School of Public Health801 Massachusetts Avenue 3rd FloorBostonMassachusetts02118USA
| | - John J. Farrell
- Department of Medicine (Biomedical Genetics)Boston University School of Medicine72 East Concord StreetBostonMassachusetts02118USA
| | - Tong Tong
- Department of Medicine (Biomedical Genetics)Boston University School of Medicine72 East Concord StreetBostonMassachusetts02118USA
| | - Junming Hu
- Department of Medicine (Biomedical Genetics)Boston University School of Medicine72 East Concord StreetBostonMassachusetts02118USA
| | - Congcong Zhu
- Department of Medicine (Biomedical Genetics)Boston University School of Medicine72 East Concord StreetBostonMassachusetts02118USA
| | | | - Li‐San Wang
- Department of Pathology and Laboratory MedicineUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvania19104USA
| | - Richard Mayeux
- Department of NeurologyColumbia UniversityNew YorkNew York10032USA
| | - Jonathan L. Haines
- Department of Population and Quantitative Health Sciences Case Western Reserve UniversityClevelandOhio44106USA
| | | | - Gerard D. Schellenberg
- Department of Pathology and Laboratory MedicineUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvania19104USA
| | - Kathryn L. Lunetta
- Department of BiostatisticsBoston University School of Public Health801 Massachusetts Avenue 3rd FloorBostonMassachusetts02118USA
| | - Lindsay A. Farrer
- Department of Medicine (Biomedical Genetics)Boston University School of Medicine72 East Concord StreetBostonMassachusetts02118USA
- Department of BiostatisticsBoston University School of Public Health801 Massachusetts Avenue 3rd FloorBostonMassachusetts02118USA
- Department of NeurologyBoston University School of MedicineBostonMassachusetts02118USA
- Department of OphthalmologyBoston University School of MedicineBostonMassachusetts02118USA
- Department of EpidemiologyBoston University School of Public Health715 Albany StreetBostonMassachusetts02118USA
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19
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Billah T, Gordon L, Schoenfeld EM, Chang BP, Hess EP, Probst MA. Clinicians' perspectives on the implementation of patient decision aids in the emergency department: A qualitative interview study. J Am Coll Emerg Physicians Open 2022; 3:e12629. [PMID: 35079731 PMCID: PMC8769071 DOI: 10.1002/emp2.12629] [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: 08/26/2021] [Revised: 10/22/2021] [Accepted: 11/09/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Decision aids (DAs) are tools to facilitate and standardize shared decision making (SDM). Although most emergency clinicians (ECs) perceive SDM appropriate for emergency care, there is limited uptake of DAs in clinical practice. The objective of this study was to explore barriers and facilitators identified by ECs regarding the implementation of DAs in the emergency department (ED). METHODS We conducted a qualitative interview study guided by implementation science frameworks. ECs participated in interviews focused on the implementation of DAs for the disposition of patients with low-risk chest pain and unexplained syncope in the ED. Interviews were recorded and transcribed verbatim. We then iteratively developed a codebook with directed qualitative content analysis. RESULTS We approached 25 ECs working in urban New York, of whom 20 agreed to be interviewed (mean age, 41 years; 25% women). The following 6 main barriers were identified: (1) poor DA accessibility, (2) concern for increased medicolegal risk, (3) lack of perceived need for a DA, (4) patient factors including lack of capacity and limited health literacy, (5) skepticism about validity of DAs, and (6) lack of time to use DAs. The 6 main facilitators identified were (1) positive attitudes toward SDM, (2) patient access to follow-up care, (3) potential for improved patient satisfaction, (4) potential for improved risk communication, (5) strategic integration of DAs into the clinical workflow, and (6) institutional support of DAs. CONCLUSIONS ECs identified multiple barriers and facilitators to the implementation of DAs into clinical practice. These findings could guide implementation efforts targeting the uptake of DA use in the ED.
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Affiliation(s)
- Tausif Billah
- Department of Emergency MedicineIcahn School of Medicine at Mount SinaiMount Sinai HospitalNew YorkNew YorkUSA
| | - Lauren Gordon
- Department of Emergency MedicineIcahn School of Medicine at Mount SinaiMount Sinai HospitalNew YorkNew YorkUSA
| | - Elizabeth M. Schoenfeld
- Department of Emergency MedicineUniversity of Massachusetts Medical School–BaystateSpringfieldMassachusettsUSA
| | - Bernard P. Chang
- Department of Emergency MedicineColumbia University Medical CenterNew YorkNew YorkUSA
| | - Erik P. Hess
- Department of Emergency MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Marc A. Probst
- Department of Emergency MedicineIcahn School of Medicine at Mount SinaiMount Sinai HospitalNew YorkNew YorkUSA
- Department of Emergency MedicineColumbia University Medical CenterNew YorkNew YorkUSA
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20
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Chowdhury SM, Graham EM, Taylor CL, Savage A, McHugh KE, Gaydos S, Nutting AC, Zile MR, Atz AM. Diastolic Dysfunction With Preserved Ejection Fraction After the Fontan Procedure. J Am Heart Assoc 2022; 11:e024095. [PMID: 35023347 PMCID: PMC9238510 DOI: 10.1161/jaha.121.024095] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/16/2021] [Indexed: 01/08/2023]
Abstract
Background Heart failure phenotyping in single-ventricle Fontan patients is challenging, particularly in patients with normal ejection fraction (EF). The objective of this study was to identify Fontan patients with abnormal diastolic function, who are high risk for heart failure with preserved ejection fraction (HFpEF), and characterize their cardiac mechanics, exercise function, and functional health status. Methods and Results Data were obtained from the Pediatric Heart Network Fontan Cross-sectional Study database. EF was considered abnormal if <50%. Diastolic function was defined as abnormal if the diastolic pressure:volume quotient (lateral E:e'/end-diastolic volume) was >90th percentile (≥0.26 mL-1). Patients were divided into: controls=normal EF and diastolic function; systolic dysfunction (SD) = abnormal EF with normal diastolic function; diastolic dysfunction (DD) = normal EF with abnormal diastolic pressure:volume quotient. Exercise function was quantified as percent predicted peak VO2. Physical Functioning Summary Score (FSS) was reported from the Child Health Questionnaire. A total of 239 patients were included, 177 (74%) control, 36 (15%) SD, and 26 (11%) DD. Median age was 12.2 (5.4) years. Arterial elastance, a measure of arterial stiffness, was higher in DD (3.6±1.1 mm Hg/mL) compared with controls (2.5±0.8 mm Hg/mL), P<0.01. DD patients had lower predicted peak VO2 compared with controls (52% [20] versus 67% [23], P<0.01). Physical FSS was lower in DD (45±13) and SD (44±13) compared with controls (50±7), P<0.01. Conclusions Fontan patients with abnormal diastolic function and normal EF have decreased exercise tolerance, decreased functional health status, and elevated arterial stiffness. Identification of patients at high risk for HFpEF is feasible and should be considered when evaluating Fontan patients.
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Affiliation(s)
- Shahryar M. Chowdhury
- Division of CardiologyDepartment of PediatricsMedical University of South CarolinaCharlestonSC
| | - Eric M. Graham
- Division of CardiologyDepartment of PediatricsMedical University of South CarolinaCharlestonSC
| | - Carolyn L. Taylor
- Division of CardiologyDepartment of PediatricsMedical University of South CarolinaCharlestonSC
| | - Andrew Savage
- Division of CardiologyDepartment of PediatricsMedical University of South CarolinaCharlestonSC
| | - Kimberly E. McHugh
- Division of CardiologyDepartment of PediatricsMedical University of South CarolinaCharlestonSC
| | - Stephanie Gaydos
- Division of CardiologyDepartment of MedicineMedical University of South CarolinaCharlestonSC
| | - Arni C. Nutting
- Division of CardiologyDepartment of PediatricsMedical University of South CarolinaCharlestonSC
| | - Michael R. Zile
- Division of CardiologyDepartment of MedicineMedical University of South CarolinaCharlestonSC
| | - Andrew M. Atz
- Division of CardiologyDepartment of PediatricsMedical University of South CarolinaCharlestonSC
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Hsieh L, Grifoni A, Sidney J, Shimizu C, Shike H, Ramchandar N, Moreno E, Tremoulet AH, Burns JC, Franco A. Characterization of SARS-CoV-2 and common cold coronavirus-specific T-cell responses in MIS-C and Kawasaki disease children. Eur J Immunol 2022; 52:123-137. [PMID: 34599760 PMCID: PMC8646471 DOI: 10.1002/eji.202149556] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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: 08/02/2021] [Revised: 09/01/2021] [Accepted: 09/27/2021] [Indexed: 01/06/2023]
Abstract
The immunopathogenesis of multisystem inflammatory syndrome (MIS-C) in children that may follow exposure to SARS-CoV-2 is incompletely understood. Here, we studied SARS-CoV-2-specific T cells in MIS-C, Kawasaki disease (KD), and SARS-CoV-2 convalescent controls using peptide pools derived from SARS-CoV-2 spike or nonspike proteins, and common cold coronaviruses (CCC). Coordinated CD4+ and CD8+ SARS-CoV-2-specific T cells were detected in five MIS-C subjects with cross-reactivity to CCC. CD4+ and CD8+ T-cell responses alone were documented in three and one subjects, respectively. T-cell specificities in MIS-C did not correlate with disease severity and were similar to SARS-CoV-2 convalescent controls. T-cell memory and cross-reactivity to CCC in MIS-C and SARS-CoV-2 convalescent controls were also similar. The chemokine receptor CCR6, but not CCR9, was highly expressed on SARS-CoV-2-specific CD4+ but not on CD8+ T cells. Only two of 10 KD subjects showed a T-cell response to CCC. Enumeration of myeloid APCs revealed low cell precursors in MIS-C subjects compared to KD. In summary, children with MIS-C mount a normal T-cell response to SARS-CoV-2 with no apparent relationship to antecedent CCC exposure. Low numbers of tolerogenic myeloid DCs may impair their anti-inflammatory response.
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Affiliation(s)
- Li‐En Hsieh
- Department of PediatricsSchool of MedicineUniversity of California, San DiegoLa JollaCAUSA
| | - Alba Grifoni
- Division of Vaccine DiscoveryLa Jolla Institute for ImmunologyLa JollaCAUSA
| | - John Sidney
- Division of Vaccine DiscoveryLa Jolla Institute for ImmunologyLa JollaCAUSA
| | - Chisato Shimizu
- Department of PediatricsSchool of MedicineUniversity of California, San DiegoLa JollaCAUSA
| | - Hiroko Shike
- Department of Pathology and Laboratory MedicinePenn State Milton S. Hershey Medical CenterHersheyPAUSA
| | - Nanda Ramchandar
- Department of PediatricsSchool of MedicineUniversity of California, San DiegoLa JollaCAUSA
| | - Elizabeth Moreno
- Department of PediatricsSchool of MedicineUniversity of California, San DiegoLa JollaCAUSA
| | - Adriana H. Tremoulet
- Department of PediatricsSchool of MedicineUniversity of California, San DiegoLa JollaCAUSA
| | - Jane C. Burns
- Department of PediatricsSchool of MedicineUniversity of California, San DiegoLa JollaCAUSA
| | - Alessandra Franco
- Department of PediatricsSchool of MedicineUniversity of California, San DiegoLa JollaCAUSA
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22
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Gotts JE, Maishan M, Chun L, Fang X, Han C, Chiueh V, Khakoo AY, Lee T, Stolina M, Matthay MA. Delayed angiopoietin-2 blockade reduces influenza-induced lung injury and improves survival in mice. Physiol Rep 2021; 9:e15081. [PMID: 34755490 PMCID: PMC8578883 DOI: 10.14814/phy2.15081] [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: 09/07/2021] [Revised: 09/21/2021] [Accepted: 09/25/2021] [Indexed: 11/24/2022] Open
Abstract
Influenza remains a major cause of death and disability with limited treatment options. Studies of acute lung injury have identified angiopoietin-2 (Ang-2) as a key prognostic marker and a potential mediator of Acute respiratory distress syndrome. However, the role of Ang-2 in viral pneumonia remains poorly defined. This study characterized the time course of lung Ang-2 expression in severe influenza pneumonia and tested the therapeutic potential of Ang-2 inhibition. We inoculated adult mice with influenza A (PR8 strain) and measured angiopoietin-1 (Ang-1), Ang-2, and Tie2 expressions during the evolution of inflammatory lung injury over the first 7 days post-infection (dpi). We tested a peptide-antibody inhibitor of Ang-2, L1-7, administered at 2, 4, and 6 dpi and measured arterial oxygen saturation, survival, pulmonary edema, inflammatory cytokines, and viral load. Finally, we infected primary human alveolar type II epithelial (AT2) cells grown in air-liquid interface culture with influenza and measured Ang-2 RNA expression. Influenza caused severe lung injury between 5 and 7 dpi in association with increased Ang-2 lung RNA and a dramatic increase in Ang-2 protein in bronchoalveolar lavage. Inhibition of Ang-2 improved oxygenation and survival and reduced pulmonary edema and alveolar-capillary barrier permeability to protein without major effects on inflammation or viral load. Finally, influenza increased the expression of Ang-2 RNA in human AT2 cells. The increased Ang-2 levels in the airspaces during severe influenza pneumonia and the improvement in clinically relevant outcomes after Ang-2 antagonism suggest that the Ang-1/Ang-2 Tie-2 signaling axis is a promising therapeutic target in influenza and potentially other causes of viral pneumonia.
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Affiliation(s)
- Jeffrey E. Gotts
- Departments of Medicine and AnesthesiaCardiovascular Research InstituteUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Mazharul Maishan
- Departments of Medicine and AnesthesiaCardiovascular Research InstituteUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Lauren Chun
- Departments of Medicine and AnesthesiaCardiovascular Research InstituteUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Xiaohui Fang
- Departments of Medicine and AnesthesiaCardiovascular Research InstituteUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Chun‐Ya Han
- Department of Cardiometabolic DisordersAmgen ResearchThousand OaksCaliforniaUSA
| | - Venice Chiueh
- Department of Cardiometabolic DisordersAmgen ResearchThousand OaksCaliforniaUSA
| | - Aarif Y. Khakoo
- Department of Cardiometabolic DisordersAmgen ResearchThousand OaksCaliforniaUSA
| | - TaeWeon Lee
- Department of Cardiometabolic DisordersAmgen ResearchThousand OaksCaliforniaUSA
| | - Marina Stolina
- Department of Cardiometabolic DisordersAmgen ResearchThousand OaksCaliforniaUSA
| | - Michael A. Matthay
- Departments of Medicine and AnesthesiaCardiovascular Research InstituteUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
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Majid DSA, Castillo A. Angiotensin II-induced natriuresis is attenuated in knockout mice lacking the receptors for tumor necrosis factor-α. Physiol Rep 2021; 9:e14942. [PMID: 34337896 PMCID: PMC8326895 DOI: 10.14814/phy2.14942] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/25/2022] Open
Abstract
Intravenous infusion of relatively higher doses of angiotensin II (AngII) elicits natriuresis as opposed to its usual anti-natruretic response. As AngII can induce tumor necrosis factor-α (TNFα) production which elicits natriuresis via its action on TNFα receptor type 1 (TNFR1), we hypothesize that the concomitant release of TNFα contributes to the natriuretic response to AngII. Responses to AngII infusion (1 ng min-1 g-1 for 75 min, iv) were evaluated in anesthetized knockout (KO) mice lacking TNFR1 (n = 6) and TNFR2 (TNFα receptor type 2; n = 6) and compared these responses with those in wild type (WT; n = 6) mice. Arterial pressure (AP) was recorded from a cannula placed in the carotid artery. Renal blood flow (RBF) and glomerular filtration rate (GFR) were measured by PAH and inulin clearances, respectively. Urine was collected from a catheter placed in the bladder. AngII caused similar increases (p < 0.05 vs basal values) in AP (WT, 37 ± 5%; TNFR1KO, 35 ± 4%; TNFR2KO, 30 ± 4%) and decreases (p < 0.05) in RBF (WT, -39 ± 5%; TNFR1KO, -28 ± 6%; TNFR2KO, -31 ± 4%) without significant changes in GFR (WT, -17 ± 7%; TNFR1KO, -18 ± 7%; TNFR2KO, -12 ± 7%). However, despite similar changes in AP and renal hemodynamics, AngII induced increases (p < 0.05) in urinary sodium excretion in WT (3916 ± 942%) were less in the KO strains, more or less in TNFR1KO (473 ± 170%) than in TNFR2KO (1176 ± 168%). These data indicate that TNF-α receptors, particularly TNFR1 are involved in the natriuretic response that occur during acute infusion of AngII and thus, plays a protective role in preventing excessive salt retention at clinical conditions associated with elevated AngII level.
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Affiliation(s)
- Dewan S. A. Majid
- Department of PhysiologyTulane Hypertension & Renal Center of ExcellenceTulane University Health Sciences CenterNew OrleansLAUSA
| | - Alexander Castillo
- Department of PhysiologyTulane Hypertension & Renal Center of ExcellenceTulane University Health Sciences CenterNew OrleansLAUSA
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