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Warner II ER, Satapathy SK. Sarcopenia in the Cirrhotic Patient: Current Knowledge and Future Directions. J Clin Exp Hepatol 2023; 13:162-177. [PMID: 36647414 PMCID: PMC9840086 DOI: 10.1016/j.jceh.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 06/13/2022] [Indexed: 02/07/2023] Open
Abstract
Cirrhosis predisposes to abnormalities in energy, hormonal, and immunological homeostasis. Disturbances in these metabolic processes create susceptibility to sarcopenia or pathological muscle wasting. Sarcopenia is prevalent in cirrhosis and its presence portends significant adverse outcomes including the length of hospital stay, infectious complications, and mortality. This highlights the importance of identification of at-risk individuals with early nutritional, therapeutic and physical therapy intervention. This manuscript summarizes literature relevant to sarcopenia in cirrhosis, describes current knowledge, and elucidates possible future directions.
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Key Words
- ACE, angiotensin-converting enzyme
- ACE-I, angiotensin-converting enzyme inhibitor
- AKI, acute kidney injury
- ALM, appendicular lean mass
- ARB, angiotensin receptor blocker
- ASM, appendicular skeletal mass
- AT1R, angiotensin type 1 receptor
- AT2R, angiotensin type 2 receptor
- ATP, adenosine-5′-triphosphate
- AWGS, Asian Working Group for Sarcopenia
- BCAA, branched chained amino acids
- BIA, bioelectrical impedance analysis
- BMI, body mass index
- CART, classification and regression tree
- CKD, chronic kidney disease
- CRP, C-reactive protein
- DEXA, dual energy X-ray absorptiometry
- EAA, essential amino acids
- ESPEN-SIG, European Society for Clinical Nutrition and Metabolism Special Interests Groups
- ESRD, end-stage renal disease
- EWGSOP, European Working Group on Sarcopenia in Older People
- FAD, flavin adenine dinucleotide
- FADH2, flavin adenine dinucleotide +2 hydrogen
- FNIH, Foundation for the National Institutes of Health
- GTP, guanosine-5′-triphosphate
- GnRH, gonadotrophin-releasing hormone
- HCC, hepatocellular carcinoma
- HPT, hypothalamic-pituitary-testicular
- IFN-γ, interferon γ
- IGF-1, insulin-like growth factor 1
- IL-1, interleukin-1
- IL-6, interleukin-6
- IWGS, International Working Group on Sarcopenia
- LH, luteinizing hormone
- MELD, Model for End-Stage Liver Disease
- MuRF1, muscle RING-finger-1
- NAD, nicotinamide adenine dinucleotide
- NADH, nicotinamide adenine dinucleotide + hydrogen
- NADPH, nicotinamide adenine dinucleotide phosphate
- NAFLD, non-alcoholic fatty liver disease
- NASH, non-alcoholic steatohepatitis
- NF-κβ, nuclear factor κβ
- NHANES, National Health and Nutritional Examination Survey
- PMI, psoas muscle index
- PMTH, psoas muscle thickness
- RAAS, renin-angiotensin-aldosterone system
- ROS, reactive oxygen species
- SARC-F, Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls
- SHBG, sex hormone binding globulin
- SMI, skeletal muscle index
- SNS, sympathetic nervous system
- SPPB, Short Performance Physical Battery
- TNF-α, tumor necrosis factor α
- UCSF, University of California, San Francisco
- UNOS, United Network of Organ Sharing
- cirrhosis
- energy
- mTOR, mammalian target of rapamycin
- metabolism
- muscle
- sarcopenia
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Affiliation(s)
- Edgewood R. Warner II
- Department of Medicine, Donald and Barbara Zucker School of Medicine/Northwell Health, 300 Community Drive, Manhasset, NY, 11030, USA
| | - Sanjaya K. Satapathy
- Division of Hepatology and Northwell Health Center for Liver Diseases and Transplantation, Department of Medicine, Donald and Barbara Zucker School of Medicine/Northwell Health, 300 Community Drive, Manhasset, NY, 11030, USA
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Elshafei A, Khidr EG, El-Husseiny AA, Gomaa MH. RAAS, ACE2 and COVID-19; a mechanistic review. Saudi J Biol Sci 2021; 28:6465-6470. [PMID: 34305426 PMCID: PMC8270731 DOI: 10.1016/j.sjbs.2021.07.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/26/2021] [Accepted: 07/04/2021] [Indexed: 01/08/2023] Open
Abstract
The use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) in coronavirus disease 2019 (COVID-19) patients has been claimed as associated with the risk of COVID-19 infection and its subsequent morbidities and mortalities. These claims were resulting from the possibility of upregulating the expression of angiotensin-converting enzyme 2 (ACE2), facilitation of SARS-CoV-2 entry, and increasing the susceptibility of infection in such treated cardiovascular patients. ACE2 and renin-angiotensin-aldosterone system (RAAS) products have a critical function in controlling the severity of lung injury, fibrosis, and failure following the initiation of the disease. This review is to clarify the mechanisms beyond the possible deleterious effects of angiotensin II (Ang II), and the potential protective role of angiotensin 1-7 (Ang 1-7) against pulmonary fibrosis, with a subsequent discussion of the latest updates on ACEIs/ARBs use and COVID-19 susceptibility in the light of these mechanisms and biochemical explanation.
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Key Words
- ACE1, angiotensin-converting enzyme 1
- ACE2
- ACE2, angiotensin-converting enzyme 2
- ACEIs
- ACEIs, angiotensin-converting enzyme inhibitors
- AEC-II, alveolar epithelial type II cells
- ARBs
- ARBs, angiotensin receptor blockers
- AT1R, angiotensin type 1 receptor
- AT2R, angiotensin type 2 receptor
- Ang 1-7, angiotensin 1-7
- Ang 1-9, angiotensin 1-9
- AngI, angiotensin I
- AngII, angiotensin II
- Angiotensin 1–7
- Angiotensin II
- COVID-19
- COVID-19, coronavirus disease 2019
- CVD, cardiovascular disease
- ERK, extracellular signal-regulated kinase
- ICU, intensive care unit
- MAPK, mitogen-activated protein kinase
- NLRP3, (NOD, LRR, and pyrin domain-containing protein 3)
- RAAS, renin-angiotensin-aldosterone system
- TGF-β, transforming growth factor-beta
- miR-21, microRNA-21
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Affiliation(s)
- Ahmed Elshafei
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy, Al-Azhar University, Nasr City 11231, Cairo, Egypt
| | - Emad Gamil Khidr
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy, Al-Azhar University, Nasr City 11231, Cairo, Egypt
| | - Ahmed A. El-Husseiny
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy, Al-Azhar University, Nasr City 11231, Cairo, Egypt
| | - Maher H. Gomaa
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy, Al-Azhar University, Nasr City 11231, Cairo, Egypt
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Kashihara T, Kawagishi H, Nakada T, Numaga-Tomita T, Kadota S, Wolf EE, Du CK, Shiba Y, Morimoto S, Yamada M. β-Arrestin-Biased AT 1 Agonist TRV027 Causes a Neonatal-Specific Sustained Positive Inotropic Effect Without Increasing Heart Rate. JACC Basic Transl Sci 2020; 5:1057-1069. [PMID: 33294739 PMCID: PMC7691286 DOI: 10.1016/j.jacbts.2020.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/31/2020] [Accepted: 08/31/2020] [Indexed: 01/14/2023]
Abstract
The treatment of pediatric heart failure is a long-standing unmet medical need. Angiotensin II supports mammalian perinatal circulation by activating cardiac L-type Ca2+ channels through angiotensin type 1 receptor (AT1R) and β-arrestin. TRV027, a β-arrestin-biased AT1R agonist, that has been reported to be safe but not effective for adult patients with heart failure, activates the AT1R/β-arrestin pathway. We found that TRV027 evokes a long-acting positive inotropic effect specifically on immature cardiac myocytes through the AT1R/β-arrestin/L-type Ca2+ channel pathway with minimum effect on heart rate, oxygen consumption, reactive oxygen species production, and aldosterone secretion. Thus, TRV027 could be utilized as a valuable drug specific for pediatric heart failure.
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Key Words
- AT1R, angiotensin type 1 receptor
- AngII, angiotensin II
- BBA, β-arrestin–biased angiotensin type 1 receptor agonist
- ECG, electrocardiography
- GPCR, G protein–coupled receptor
- LTCC, CaV1.2 L-type Ca2+ channel
- OCR, oxygen consumption rate
- PHF, pediatric heart failure
- ROS, reactive oxygen species
- TRV027
- UCG, ultrasound cardiogram
- congenital dilated cardiomyopathy
- hiPSC-CM, human induced pluripotent stem cell–derived cardiac myocyte
- human induced pluripotent stem cell-derived cardiac myocytes
- inotropic vasodilator
- mNVCM, mouse neonatal ventricular cardiac myocyte
- neonate
- pediatric heart failure
- β-arrestin–biased AT1 angiotensin receptor agonist
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Affiliation(s)
- Toshihide Kashihara
- Department of Molecular Pharmacology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroyuki Kawagishi
- Department of Molecular Pharmacology, Shinshu University School of Medicine, Matsumoto, Japan.,Department of Biotechnology, Institute for Biomedical Sciences, Shinshu University, Matsumoto, Japan
| | - Tsutomu Nakada
- Department of Instrumental Analysis, Research Center for Supports to Advanced Science, Shinshu University, Matsumoto, Japan
| | - Takuro Numaga-Tomita
- Department of Molecular Pharmacology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shin Kadota
- Department of Biotechnology, Institute for Biomedical Sciences, Shinshu University, Matsumoto, Japan.,Department of Regenerative Science and Medicine, School of Medicine, Shinshu University, Matsumoto, Japan
| | - Elena E Wolf
- Division of Nephrology and Division of Vascular Endothelium and Microcirculation, Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Cheng-Kun Du
- Department of Cardiac Physiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan
| | - Yuji Shiba
- Department of Biotechnology, Institute for Biomedical Sciences, Shinshu University, Matsumoto, Japan.,Department of Regenerative Science and Medicine, School of Medicine, Shinshu University, Matsumoto, Japan
| | - Sachio Morimoto
- School of Health Sciences Fukuoka, International University of Health and Welfare, Okawa, Japan
| | - Mitsuhiko Yamada
- Department of Molecular Pharmacology, Shinshu University School of Medicine, Matsumoto, Japan
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Li S, Case AJ, Yang RF, Schultz HD, Zimmerman MC. Over-expressed copper/zinc superoxide dismutase localizes to mitochondria in neurons inhibiting the angiotensin II-mediated increase in mitochondrial superoxide. Redox Biol 2013; 2:8-14. [PMID: 24363997 PMCID: PMC3863132 DOI: 10.1016/j.redox.2013.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 11/07/2013] [Indexed: 01/13/2023] Open
Abstract
Angiotensin II (AngII) is the main effector peptide of the renin–angiotensin system (RAS), and contributes to the pathogenesis of cardiovascular disease by exerting its effects on an array of different cell types, including central neurons. AngII intra-neuronal signaling is mediated, at least in part, by reactive oxygen species, particularly superoxide (O2•−). Recently, it has been discovered that mitochondria are a major subcellular source of AngII-induced O2•−. We have previously reported that over-expression of manganese superoxide dismutase (MnSOD), a mitochondrial matrix-localized O2•− scavenging enzyme, inhibits AngII intra-neuronal signaling. Interestingly, over-expression of copper/zinc superoxide dismutase (CuZnSOD), which is believed to be primarily localized to the cytoplasm, similarly inhibits AngII intra-neuronal signaling and provides protection against AngII-mediated neurogenic hypertension. Herein, we tested the hypothesis that CuZnSOD over-expression in central neurons localizes to mitochondria and inhibits AngII intra-neuronal signaling by scavenging mitochondrial O2•−. Using a neuronal cell culture model (CATH.a neurons), we demonstrate that both endogenous and adenovirus-mediated over-expressed CuZnSOD (AdCuZnSOD) are present in mitochondria. Furthermore, we show that over-expression of CuZnSOD attenuates the AngII-mediated increase in mitochondrial O2•− levels and the AngII-induced inhibition of neuronal potassium current. Taken together, these data clearly show that over-expressed CuZnSOD in neurons localizes in mitochondria, scavenges AngII-induced mitochondrial O2•−, and inhibits AngII intra-neuronal signaling. Endogenous CuZnSOD is localized to mitochondria of AngII-sensitive neurons. Adenovirus-mediated over-expressed CuZnSOD is localized to neuron mitochondria. AngII-induced mitochondrial O2•− flux is attenuated by CuZnSOD over-expression. Over-expressed CuZnSOD reduces AngII-mediated inhibition of neuronal K+ current.
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Affiliation(s)
- Shumin Li
- Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Adam J Case
- Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Rui-Fang Yang
- Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Harold D Schultz
- Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA ; Redox Biology Center, University of Nebraska - Lincoln, Lincoln, NE, USA
| | - Matthew C Zimmerman
- Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA ; Redox Biology Center, University of Nebraska - Lincoln, Lincoln, NE, USA
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