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Zhu J, Yang L, Jia Y, Balistrieri A, Fraidenburg DR, Wang J, Tang H, Yuan JXJ. Pathogenic Mechanisms of Pulmonary Arterial Hypertension: Homeostasis Imbalance of Endothelium-Derived Relaxing and Contracting Factors. JACC Asia 2022; 2:787-802. [PMID: 36713766 PMCID: PMC9877237 DOI: 10.1016/j.jacasi.2022.09.010] [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] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 08/29/2022] [Accepted: 09/14/2022] [Indexed: 12/23/2022]
Abstract
Pulmonary arterial hypertension (PAH) is a progressive and fatal disease. Sustained pulmonary vasoconstriction and concentric pulmonary vascular remodeling contribute to the elevated pulmonary vascular resistance and pulmonary artery pressure in PAH. Endothelial cells regulate vascular tension by producing endothelium-derived relaxing factors (EDRFs) and endothelium-derived contracting factors (EDCFs). Homeostasis of EDRF and EDCF production has been identified as a marker of the endothelium integrity. Impaired synthesis or release of EDRFs induces persistent vascular contraction and pulmonary artery remodeling, which subsequently leads to the development and progression of PAH. In this review, the authors summarize how EDRFs and EDCFs affect pulmonary vascular homeostasis, with special attention to the recently published novel mechanisms related to endothelial dysfunction in PAH and drugs associated with EDRFs and EDCFs.
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Key Words
- 5-HT, 5-hydroxytryptamine
- ACE, angiotensin-converting enzyme
- EC, endothelial cell
- EDCF, endothelium-derived contracting factor
- EDRF, endothelium-derived relaxing factor
- ET, endothelin
- PAH, pulmonary arterial hypertension
- PASMC, pulmonary artery smooth muscle cell
- PG, prostaglandin
- TPH, tryptophan hydroxylase
- TXA2, thromboxane A2
- cGMP, cyclic guanosine monophosphate
- endothelial dysfunction
- endothelium-derived relaxing factor
- pulmonary arterial hypertension
- vascular homeostasis
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Affiliation(s)
- Jinsheng Zhu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangdong Key Laboratory of Vascular Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lei Yang
- College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Yangfan Jia
- College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Angela Balistrieri
- Section of Physiology, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Dustin R. Fraidenburg
- Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Jian Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangdong Key Laboratory of Vascular Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Section of Physiology, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Haiyang Tang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangdong Key Laboratory of Vascular Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Addresses for correspondence: Dr Haiyang Tang, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 195 West Dongfeng Road, Guangzhou, Guangdong 510120, China.
| | - Jason X-J Yuan
- Section of Physiology, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA,Dr Jason X.-J. Yuan, Section of Physiology, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California-San Diego, 9500 Gilman Drive, MC 0856, La Jolla, California 92093-0856, USA.
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Yu Q, Wu C, Chen Y, Li B, Wang R, Huang R, Li X, Gu D, Wang X, Duan X, Li S, Liu Y, Wu W, Hennenberg M, Zeng G. Inhibition of LIM kinase reduces contraction and proliferation in bladder smooth muscle. Acta Pharm Sin B 2021; 11:1914-1930. [PMID: 34386328 PMCID: PMC8343115 DOI: 10.1016/j.apsb.2021.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/17/2020] [Accepted: 11/03/2020] [Indexed: 01/03/2023] Open
Abstract
Overactive bladder (OAB) is the most bothersome symptom in lower urinary tract symptoms (LUTS). Current pharmacologic treatment aims to inhibit detrusor contraction; however, shows unsatisfied efficacy and high discontinuation rate. LIM kinases (LIMKs) promote smooth muscle contraction in the prostate; however, their function in the bladder smooth muscle remains unclear. Here, we studied effects of the LIMK inhibitors on bladder smooth muscle contraction and proliferation both in vitro and in vivo experiments. Bladder expressions of LIMKs are elevated in OAB rat detrusor tissues. Two LIMK inhibitors, SR7826 and LIMKi3, inhibit contraction of human detrusor strip, and cause actin filament breakdown, as well as cell proliferation reduction in cultured human bladder smooth muscle cells (HBSMCs), paralleled by reduced cofilin phosphorylation. Silencing of LIMK1 and LIMK2 in HBSMCs resulted in breakdown of actin filaments and decreased cell proliferation. Treatment with SR7826 or LIMKi3 decreased micturition frequency and bladder detrusor hypertrophy in rats with bladder outlet obstruction. Our study suggests that LIMKs may promote contraction and proliferation in the bladder smooth muscle, which could be inhibited by small molecule LIMK inhibitors. LIMK inhibitors could be a potential therapeutic strategy for OAB- related LUTS.
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Key Words
- 4E-BP1, 4E-binding protein 1
- ADF, actin depolymerizing factors
- BOO, bladder outlet obstruction
- BPH, benign prostatic hyperplasia
- Bladder smooth muscle contraction
- CCK-8, Cell Counting Kit-8
- Cofilin phosphorylation
- Ct, number of cycles
- DMSO, dimethyl sulfoxide
- EdU, 5-ethynyl-2′-deoxyuridine
- GAPDH, glyceraldehyde 3-phosphate dehydrogenase
- H&E, hematoxylin and eosin
- HBSMCs, human bladder smooth muscle cells
- HRP, horseradish peroxidase
- LIMK
- LIMKs, LIM kinases
- LUTS, lower urinary tract symptoms
- Lower urinary tract symptoms (LUTS)
- MLC, myosin light chain
- MW, molecular weight
- MYPT1, myosin-binding subunit
- OAB, overactive bladder
- Overactive bladder (OAB)
- PCNA, proliferating cell nuclear antigen
- RT-qPCR, reverse transcription and quantitative polymerase chain reaction
- STK16, serine/threonine kinase 16
- TESK1, testicular protein kinase 1
- TXA2, thromboxane A2
- WST-8, 2-(2-methoxy-4-nitrophenyl)-3-(4-nitrophenyl)-5-(2,4-disulfophenyl)-2H-tetrazolium monosodium salt
- siRNA, small interfering RNA
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Affiliation(s)
- Qingfeng Yu
- Department of Urology and Guangdong Key Laboratory of Urology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510230, China
| | - Chengjie Wu
- Department of Urology and Guangdong Key Laboratory of Urology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510230, China
| | - Yeda Chen
- Department of Urology and Guangdong Key Laboratory of Urology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510230, China
| | - Bingsheng Li
- Department of Urology, University Hospital, LMU Munich, Munich 81377, Germany
| | - Ruixiao Wang
- Department of Urology, University Hospital, LMU Munich, Munich 81377, Germany
| | - Ru Huang
- Department of Urology, University Hospital, LMU Munich, Munich 81377, Germany
| | - Xuechun Li
- Department of Urology and Guangdong Key Laboratory of Urology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510230, China
| | - Di Gu
- Department of Urology and Guangdong Key Laboratory of Urology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510230, China
| | - Xiaolong Wang
- Department of Urology, University Hospital, LMU Munich, Munich 81377, Germany
| | - Xiaolu Duan
- Department of Urology and Guangdong Key Laboratory of Urology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510230, China
| | - Shujue Li
- Department of Urology and Guangdong Key Laboratory of Urology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510230, China
| | - Yang Liu
- Department of Urology and Guangdong Key Laboratory of Urology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510230, China
| | - Wenqi Wu
- Department of Urology and Guangdong Key Laboratory of Urology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510230, China
| | - Martin Hennenberg
- Department of Urology, University Hospital, LMU Munich, Munich 81377, Germany
| | - Guohua Zeng
- Department of Urology and Guangdong Key Laboratory of Urology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510230, China
- Corresponding author. Tel.: +86 20 34294165.
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Kritis P, Karampela I, Kokoris S, Dalamaga M. The combination of bromelain and curcumin as an immune-boosting nutraceutical in the prevention of severe COVID-19. Metabol Open 2020; 8:100066. [PMID: 33205039 PMCID: PMC7661945 DOI: 10.1016/j.metop.2020.100066] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 01/18/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is still ongoing, while no treatment has been proven effective. COVID-19 pathophysiology involves the activation of three main pathways: the inflammatory, the coagulation and the bradykinin cascades. Here, we highlight for the first time the joint potential therapeutic role of bromelain and curcumin, two well-known nutraceuticals, in the prevention of severe COVID-19. Bromelain (a cysteine protease isolated from the pineapple stem) and curcumin (a natural phenol found in turmeric) exert important immunomodulatory actions interfering in the crucial steps of COVID-19 pathophysiology. Their anti-inflammatory properties include inhibition of transcription factors and subsequent downregulation of proinflammatory mediators. They also present fibrinolytic and anticoagulant properties. Additionally, bromelain inhibits cyclooxygenase and modulates prostaglandins and thromboxane, affecting both inflammation and coagulation, and also hydrolyzes bradykinin. Interestingly, curcumin has been shown in silico studies to prevent entry of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into cells as well as viral replication, while a recent experimental study has demonstrated that bromelain may also inhibit viral entry into cells. Notably, bromelain substantially increases the absorption of curcumin after oral administration. To the best of our knowledge, this is the first report highlighting the significance of bromelain and, most importantly, the potential preventive value of the synergistic effects of bromelain and curcumin against severe COVID-19.
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Affiliation(s)
- Panagiotis Kritis
- Pulmonary and Tuberculous Diseases Private Practice, 27 K. Aitolou, 14121, Neo Iraklio, Athens, Greece
| | - Irene Karampela
- Second Department of Critical Care, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, 1 Rimini Street, 12462, Haidari, Greece
| | - Styliani Kokoris
- Laboratory of Hematology and Blood Bank Unit, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, 1 Rimini Street, 12462, Haidari, Greece
| | - Maria Dalamaga
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, 27 Mikras Asias, 11527, Goudi, Athens, Greece
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Jain V, Goel G. Acute myocardial infarction in young newbie bodybuilder using multiple steroid and protein supplements. J Cardiol Cases 2020; 21:134-6. [PMID: 32256860 DOI: 10.1016/j.jccase.2019.11.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 10/09/2019] [Accepted: 11/12/2019] [Indexed: 11/20/2022] Open
Abstract
Coronary artery disease (CAD), the major reason of deaths worldwide is generally known as a disease of the elderly, however it is grasping the youth too. The most common etiology of young CAD is lifestyle changes, smoking, and development of other comorbid conditions such as diabetes and hypertension at an early age. There has been an upward trend in youngsters regarding consciousness about their body build and thus use of various protein supplements and anabolic steroids for faster results. The present case reports a young patient presenting with severe retrosternal left-sided chest pain for 15-20 min to the emergency department. His electrocardiogram was suggestive of acute anterolateral wall ST segment elevation myocardial infarction for which he underwent urgent coronary angiography and percutaneous coronary intervention. His personal history revealed a significant use of steroids, proteins, and other supplements in supraphysiological doses for instant body building efforts without any other significant past medical, surgical, or family history. He showed good recovery and was strongly recommended to stop steroids and protein supplements. In conclusion, supraphysiological doses of protein supplements, anabolic steroids, and other nutritional products bear a risk factor for CAD. <Learning objective: This is evident from the case report that excessive supplements use by body builders for immediate mass gain and performance enhancement may lead to adverse cardiovascular complications. This is mostly prescribed by peer groups or untrained gym professionals without judging their adverse effects so we recommend a detailed history for steroid use and protein supplements in young patients presenting with acute myocardial infarction without other significant risk factors and need for counselling for use of such substances.>.
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