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Staff AC, Costa ML, Dechend R, Jacobsen DP, Sugulle M. Hypertensive disorders of pregnancy and long-term maternal cardiovascular risk: Bridging epidemiological knowledge into personalized postpartum care and follow-up. Pregnancy Hypertens 2024; 36:101127. [PMID: 38643570 DOI: 10.1016/j.preghy.2024.101127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/31/2024] [Accepted: 04/16/2024] [Indexed: 04/23/2024]
Abstract
Cardiovascular disease (CVD) is globally the leading cause of death and disability. Sex-specific causes of female CVD are under-investigated. Pregnancy remains an underinvestigated sex-specific stress test for future CVD and a hitherto missed opportunity to initiate prevention of CVD at a young age. Population-based studies show a strong association between female CVD and hypertensive disorders of pregnancy. This association is also present after other pregnancy complications that are associated with placental dysfunction, including fetal growth restriction, preterm delivery and gestational diabetes mellitus. Few women are, however, offered systematic cardio-preventive follow-up after such pregnancy complications. These women typically seek help from the health system at first clinical symptom of CVD, which may be decades later. By this time, morbidity is established and years of preventive opportunities have been missed out. Early identification of modifiable risk factors starting postpartum followed by systematic preventive measures could improve maternal cardiovascular health trajectories, promoting healthier societies. In this non-systematic review we briefly summarize the epidemiological associations and pathophysiological hypotheses for the associations. We summarize current clinical follow-up strategies, including some proposed by international and national guidelines as well as user support groups. We address modifiable factors that may be underexploited in the postpartum period, including breastfeeding and blood pressure management. We suggest a way forward and discuss the remaining knowledge gaps and barriers for securing the best evidence-based follow-up, relative to available resources after a hypertensive pregnancy complication in order to prevent or delay onset of premature CVD.
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Affiliation(s)
- Anne Cathrine Staff
- Faculty of Medicine, University of Oslo, PB 1171, Blindern, 0381 Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, PB 4956 Nydalen, 0424 Oslo, Norway.
| | - Maria Laura Costa
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (UNICAMP), Campinas/SP, Brazil
| | - Ralf Dechend
- HELIOS Clinic, Berlin, Germany; Experimental and Clinical Research Center, Charité Medical Faculty and Max-Delbrueck Center for Molecular Medicine, and HELIOS Clinic Berlin, Germany
| | - Daniel P Jacobsen
- Faculty of Medicine, University of Oslo, PB 1171, Blindern, 0381 Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, PB 4956 Nydalen, 0424 Oslo, Norway
| | - Meryam Sugulle
- Faculty of Medicine, University of Oslo, PB 1171, Blindern, 0381 Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, PB 4956 Nydalen, 0424 Oslo, Norway
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Miyauchi H, Geisberger S, Luft FC, Wilck N, Stegbauer J, Wiig H, Dechend R, Jantsch J, Kleinewietfeld M, Kempa S, Müller DN. Sodium as an Important Regulator of Immunometabolism. Hypertension 2024; 81:426-435. [PMID: 37675565 PMCID: PMC10863658 DOI: 10.1161/hypertensionaha.123.19489] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Salt sensitivity concerns blood pressure alterations after a change in salt intake (sodium chloride). The heart is a pump, and vessels are tubes; sodium can affect both. A high salt intake increases cardiac output, promotes vascular dysfunction and capillary rarefaction, and chronically leads to increased systemic vascular resistance. More recent findings suggest that sodium also acts as an important second messenger regulating energy metabolism and cellular functions. Besides endothelial cells and fibroblasts, sodium also affects innate and adaptive immunometabolism, immune cell function, and influences certain microbes and microbiota-derived metabolites. We propose the idea that the definition of salt sensitivity should be expanded beyond high blood pressure to cellular and molecular salt sensitivity.
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Affiliation(s)
- Hidetaka Miyauchi
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (H.M., S.G., F.C.L., N.W., R.D., S.K., D.N.M.)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Germany (H.M., F.C.L., N.W., R.D., D.N.M.)
- Experimental and Clinical Research Center, a joint cooperation of Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany (H.M., F.C.L., N.W., R.D., D.N.M.)
- German Centre for Cardiovascular Research, Partner Site Berlin, Germany (H.M., N.W., R.D., D.N.M.)
| | - Sabrina Geisberger
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (H.M., S.G., F.C.L., N.W., R.D., S.K., D.N.M.)
| | - Friedrich C. Luft
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (H.M., S.G., F.C.L., N.W., R.D., S.K., D.N.M.)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Germany (H.M., F.C.L., N.W., R.D., D.N.M.)
- Experimental and Clinical Research Center, a joint cooperation of Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany (H.M., F.C.L., N.W., R.D., D.N.M.)
| | - Nicola Wilck
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (H.M., S.G., F.C.L., N.W., R.D., S.K., D.N.M.)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Germany (H.M., F.C.L., N.W., R.D., D.N.M.)
- Experimental and Clinical Research Center, a joint cooperation of Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany (H.M., F.C.L., N.W., R.D., D.N.M.)
- German Centre for Cardiovascular Research, Partner Site Berlin, Germany (H.M., N.W., R.D., D.N.M.)
| | - Johannes Stegbauer
- Department of Nephrology, Faculty of Medicine, University Hospital, Heinrich-Heine-University, Düsseldorf, Germany (J.S.)
- CARID, Cardiovascular Research Institute Düsseldorf, Medical Faculty and University Hospital, Düsseldorf, Germany (J.S.)
| | - Helge Wiig
- Department of Biomedicine, University of Bergen, Norway (H.W.)
| | - Ralf Dechend
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (H.M., S.G., F.C.L., N.W., R.D., S.K., D.N.M.)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Germany (H.M., F.C.L., N.W., R.D., D.N.M.)
- Experimental and Clinical Research Center, a joint cooperation of Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany (H.M., F.C.L., N.W., R.D., D.N.M.)
- German Centre for Cardiovascular Research, Partner Site Berlin, Germany (H.M., N.W., R.D., D.N.M.)
- HELIOS Clinic, Department of Cardiology and Nephrology, Berlin, Germany (R.D.)
| | - Jonathan Jantsch
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg and University of Regensburg, Germany (J.J.)
- Institute for Medical Microbiology, Immunology, and Hygiene, and Center for Molecular Medicine Cologne, University Hospital Cologne and Faculty of Medicine, University of Cologne, Germany (J.J.)
| | - Markus Kleinewietfeld
- VIB Laboratory of Translational Immunomodulation, VIB Center for Inflammation Research, Hasselt University, Diepenbeek, Belgium (M.K.)
- Department of Immunology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium (M.K.)
- University Multiple Sclerosis Center, Hasselt University/Campus Diepenbeek, Belgium (M.K.)
| | - Stefan Kempa
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (H.M., S.G., F.C.L., N.W., R.D., S.K., D.N.M.)
| | - Dominik N. Müller
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (H.M., S.G., F.C.L., N.W., R.D., S.K., D.N.M.)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Germany (H.M., F.C.L., N.W., R.D., D.N.M.)
- Experimental and Clinical Research Center, a joint cooperation of Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany (H.M., F.C.L., N.W., R.D., D.N.M.)
- German Centre for Cardiovascular Research, Partner Site Berlin, Germany (H.M., N.W., R.D., D.N.M.)
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Bacmeister L, Goßling A, Buellesbach A, Birukov A, Myers JE, Thomas ST, Lee S, Andersen MS, Jorgensen JS, Diemert A, Blois SM, Arck PC, Hecher K, Herse F, Blankenberg S, Dechend R, Westermann D, Zeller T. High-Sensitivity Cardiac Troponin I Enhances Preeclampsia Prediction Beyond Maternal Factors and the sFlt-1/PlGF Ratio. Circulation 2024; 149:95-106. [PMID: 37982257 DOI: 10.1161/circulationaha.123.066199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/13/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Preeclampsia shares numerous risk factors with cardiovascular diseases. Here, we aimed to assess the potential utility of high-sensitivity cardiac troponin I (hs-cTnI) values during pregnancy in predicting preeclampsia occurrence. METHODS This study measured hs-cTnI levels in 3721 blood samples of 2245 pregnant women from 4 international, prospective cohorts. Three analytical approaches were used: (1) a cross-sectional analysis of all women using a single blood sample, (2) a longitudinal analysis of hs-cTnI trajectories in women with multiple samples, and (3) analyses of prediction models incorporating hs-cTnI, maternal factors, and the sFlt-1 (soluble fms-like tyrosine kinase 1)/PlGF (placental growth factor) ratio. RESULTS Women with hs-cTnI levels in the upper quarter had higher odds ratios for preeclampsia occurrence compared with women with levels in the lower quarter. Associations were driven by preterm preeclampsia (odds ratio, 5.78 [95% CI, 2.73-12.26]) and remained significant when using hs-cTnI as a continuous variable adjusted for confounders. Between-trimester hs-cTnI trajectories were independent of subsequent preeclampsia occurrence. A prediction model incorporating a practical hs-cTnI level of detection cutoff (≥1.9 pg/mL) alongside maternal factors provided comparable performance with the sFlt-1/PlGF ratio. A comprehensive model including sFlt-1/PlGF, maternal factors, and hs-cTnI provided added value (cross-validated area under the receiver operator characteristic, 0.78 [95% CI, 0.73-0.82]) above the sFlt-1/PlGF ratio alone (cross-validated area under the receiver operator characteristic, 0.70 [95% CI, 0.65-0.76]; P=0.027). As assessed by likelihood ratio tests, the addition of hs-cTnI to each prediction model significantly improved the respective prediction model not incorporating hs-cTnI, particularly for preterm preeclampsia. Net reclassification improvement analyses indicated that incorporating hs-cTnI improved risk prediction predominantly by correctly reclassifying women with subsequent preeclampsia occurrence. CONCLUSIONS These exploratory findings uncover a potential role for hs-cTnI as a complementary biomarker in the prediction of preeclampsia. After validation in prospective studies, hs-cTnI, alongside maternal factors, may either be considered as a substitute for angiogenic biomarkers in health care systems where they are sparce or unavailable, or as an enhancement to established prediction models using angiogenic markers.
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Affiliation(s)
- Lucas Bacmeister
- Clinic for Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Germany (L.B., A. Buellesbach, D.W.)
| | - Alina Goßling
- Department of Cardiology (A.G., S.B., T.Z.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Annette Buellesbach
- Clinic for Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Germany (L.B., A. Buellesbach, D.W.)
| | - Anna Birukov
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (A. Birukov)
- Department of Molecular Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal (A. Birukov)
| | - Jenny E Myers
- Maternal & Fetal Health Research Centre, Faculty Biology, Medicine & Health, University of Manchester, United Kingdom (J.E.M., S.T.T., S.L.)
| | - Susan T Thomas
- Maternal & Fetal Health Research Centre, Faculty Biology, Medicine & Health, University of Manchester, United Kingdom (J.E.M., S.T.T., S.L.)
| | - Stacy Lee
- Maternal & Fetal Health Research Centre, Faculty Biology, Medicine & Health, University of Manchester, United Kingdom (J.E.M., S.T.T., S.L.)
| | - Marianne S Andersen
- Department of Endocrinology, Odense University Hospital (M.S.A.), University of Southern Denmark, Odense
| | - Jan S Jorgensen
- Institute for Clinical Research, Faculty of Health Sciences (J.S.J.), University of Southern Denmark, Odense
| | - Anke Diemert
- Department of Obstetrics and Fetal Medicine (A.D., S.M.B., P.C.A., K.H.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sandra M Blois
- Department of Obstetrics and Fetal Medicine (A.D., S.M.B., P.C.A., K.H.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Petra C Arck
- Department of Obstetrics and Fetal Medicine (A.D., S.M.B., P.C.A., K.H.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kurt Hecher
- Department of Obstetrics and Fetal Medicine (A.D., S.M.B., P.C.A., K.H.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Herse
- Experimental and Clinical Research Center, a cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the Charité-Universitätsmedizin Berlin, Germany (F.H., R.D.)
| | - Stefan Blankenberg
- Department of Cardiology (A.G., S.B., T.Z.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- University Center for Cardiovascular Research (S.B.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research, partner site Hamburg/Kiel/Lübeck, Hamburg (S.B., T.Z.)
| | - Ralf Dechend
- Experimental and Clinical Research Center, a cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the Charité-Universitätsmedizin Berlin, Germany (F.H., R.D.)
- HELIOS Clinic Berlin-Buch, Department of Cardiology and Nephrology, Berlin, Germany (R.D.)
| | - Dirk Westermann
- Clinic for Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Germany (L.B., A. Buellesbach, D.W.)
| | - Tanja Zeller
- Department of Cardiology (A.G., S.B., T.Z.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research, partner site Hamburg/Kiel/Lübeck, Hamburg (S.B., T.Z.)
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4
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Müller FS, Aherrahrou Z, Grasshoff H, Heidorn MW, Humrich JY, Johanson L, Aherrahrou R, Reinberger T, Schulz A, ten Cate V, Robles AP, Koeck T, Rapp S, Lange T, Brachaczek L, Luebber F, Erdmann J, Heidecke H, Schulze-Forster K, Dechend R, Lackner KJ, Pfeiffer N, Ghaemi Kerahrodi J, Tüscher O, Schwarting A, Strauch K, Münzel T, Prochaska JH, Riemekasten G, Wild PS. Autoantibodies against the chemokine receptor 3 predict cardiovascular risk. Eur Heart J 2023; 44:4935-4949. [PMID: 37941454 PMCID: PMC10719496 DOI: 10.1093/eurheartj/ehad666] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 08/20/2023] [Accepted: 09/26/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND AND AIMS Chronic inflammation and autoimmunity contribute to cardiovascular (CV) disease. Recently, autoantibodies (aAbs) against the CXC-motif-chemokine receptor 3 (CXCR3), a G protein-coupled receptor with a key role in atherosclerosis, have been identified. The role of anti-CXCR3 aAbs for CV risk and disease is unclear. METHODS Anti-CXCR3 aAbs were quantified by a commercially available enzyme-linked immunosorbent assay in 5000 participants (availability: 97.1%) of the population-based Gutenberg Health Study with extensive clinical phenotyping. Regression analyses were carried out to identify determinants of anti-CXCR3 aAbs and relevance for clinical outcome (i.e. all-cause mortality, cardiac death, heart failure, and major adverse cardiac events comprising incident coronary artery disease, myocardial infarction, and cardiac death). Last, immunization with CXCR3 and passive transfer of aAbs were performed in ApoE(-/-) mice for preclinical validation. RESULTS The analysis sample included 4195 individuals (48% female, mean age 55.5 ± 11 years) after exclusion of individuals with autoimmune disease, immunomodulatory medication, acute infection, and history of cancer. Independent of age, sex, renal function, and traditional CV risk factors, increasing concentrations of anti-CXCR3 aAbs translated into higher intima-media thickness, left ventricular mass, and N-terminal pro-B-type natriuretic peptide. Adjusted for age and sex, anti-CXCR3 aAbs above the 75th percentile predicted all-cause death [hazard ratio (HR) (95% confidence interval) 1.25 (1.02, 1.52), P = .029], driven by excess cardiac mortality [HR 2.51 (1.21, 5.22), P = .014]. A trend towards a higher risk for major adverse cardiac events [HR 1.42 (1.0, 2.0), P = .05] along with increased risk of incident heart failure [HR per standard deviation increase of anti-CXCR3 aAbs: 1.26 (1.02, 1.56), P = .03] may contribute to this observation. Targeted proteomics revealed a molecular signature of anti-CXCR3 aAbs reflecting immune cell activation and cytokine-cytokine receptor interactions associated with an ongoing T helper cell 1 response. Finally, ApoE(-/-) mice immunized against CXCR3 displayed increased anti-CXCR3 aAbs and exhibited a higher burden of atherosclerosis compared to non-immunized controls, correlating with concentrations of anti-CXCR3 aAbs in the passive transfer model. CONCLUSIONS In individuals free of autoimmune disease, anti-CXCR3 aAbs were abundant, related to CV end-organ damage, and predicted all-cause death as well as cardiac morbidity and mortality in conjunction with the acceleration of experimental atherosclerosis.
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Affiliation(s)
- Felix S Müller
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- DZHK (German Centre for Cardiovascular Research), partner site RhineMain, Langenbeckstr. 1, 55131 Mainz, Germany
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Zouhair Aherrahrou
- Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Hanna Grasshoff
- Department of Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Marc W Heidorn
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- DZHK (German Centre for Cardiovascular Research), partner site RhineMain, Langenbeckstr. 1, 55131 Mainz, Germany
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jens Y Humrich
- Department of Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Laurence Johanson
- Department of Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Redouane Aherrahrou
- Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Tobias Reinberger
- Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Andreas Schulz
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Vincent ten Cate
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- DZHK (German Centre for Cardiovascular Research), partner site RhineMain, Langenbeckstr. 1, 55131 Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz,Germany
| | - Alejandro Pallares Robles
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz,Germany
| | - Thomas Koeck
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- DZHK (German Centre for Cardiovascular Research), partner site RhineMain, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Steffen Rapp
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- DZHK (German Centre for Cardiovascular Research), partner site RhineMain, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Tanja Lange
- Department of Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany
- Center of Brain, Behavior, and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
| | - Lukas Brachaczek
- Department of Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Finn Luebber
- Department of Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany
- Social Neuroscience Lab, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Jeanette Erdmann
- Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Harald Heidecke
- CellTrend Gesellschaft mit beschränkter Haftung (GmbH), Luckenwalde, Germany
| | - Kai Schulze-Forster
- CellTrend Gesellschaft mit beschränkter Haftung (GmbH), Luckenwalde, Germany
| | - Ralf Dechend
- CellTrend Gesellschaft mit beschränkter Haftung (GmbH), Luckenwalde, Germany
- Experimental and Clinical Research Center, a cooperation of Charité—Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany
- Department of Cardiology and Nephrology, HELIOS Klinikum Berlin Buch, Berlin, Germany
| | - Karl J Lackner
- DZHK (German Centre for Cardiovascular Research), partner site RhineMain, Langenbeckstr. 1, 55131 Mainz, Germany
- Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jasmin Ghaemi Kerahrodi
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Oliver Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute for Molecular Biology (IMB), Working Group Neurocognitive Mechanisms of Mental Resilience, Ackermannweg 4, 55128 Mainz, Germany
| | - Andreas Schwarting
- Department of Internal Medicine I, University Medical Center Mainz, Mainz, Germany
| | - Konstantin Strauch
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Münzel
- DZHK (German Centre for Cardiovascular Research), partner site RhineMain, Langenbeckstr. 1, 55131 Mainz, Germany
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz,Germany
| | - Jürgen H Prochaska
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- DZHK (German Centre for Cardiovascular Research), partner site RhineMain, Langenbeckstr. 1, 55131 Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz,Germany
| | - Gabriela Riemekasten
- Department of Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany
- Centre for Infection and Inflammation Lübeck (ZIEL), University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- DZHK (German Centre for Cardiovascular Research), partner site RhineMain, Langenbeckstr. 1, 55131 Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz,Germany
- Institute for Molecular Biology (IMB), Mainz, Working Group Systems Medicine, Ackermannweg 4, 55128 Mainz, Germany
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5
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Hartmann S, Botha SM, Gray CM, Valdes DS, Tong S, Kaitu'u-Lino TJ, Herse F, Bergman L, Cluver CA, Dechend R, Nonn O. Can single-cell and spatial omics unravel the pathophysiology of pre-eclampsia? J Reprod Immunol 2023; 159:104136. [PMID: 37634318 DOI: 10.1016/j.jri.2023.104136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/16/2023] [Indexed: 08/29/2023]
Abstract
Pre-eclampsia is a leading cause of maternal and fetal morbidity and mortality. Characterised by the onset of hypertension and proteinuria in the second half of pregnancy, it can lead to maternal end-organ injury such as cerebral ischemia and oedema, pulmonary oedema and renal failure, and potentially fatal outcomes for both mother and fetus. The causes of the different maternal end-organ phenotypes of pre-eclampsia and why some women develop pre-eclampsia condition early in pregnancy have yet to be elucidated. Omics methods include proteomics, genomics, metabolomics, transcriptomics. These omics techniques, previously mostly used on bulk tissue and individually, are increasingly available at a single cellular level and can be combined with each other. Multi-omics techniques on a single-cell or spatial level provide us with a powerful tool to understand the pathophysiology of pre-eclampsia. This review will explore the status of omics methods and how they can and could contribute to understanding the pathophysiology of pre-eclampsia.
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Affiliation(s)
- Sunhild Hartmann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität, Berlin, Germany; Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria 3084, Australia; Translational Obstetrics Group, The Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, Victoria 3084, Australia; Experimental and Clinical Research Center, a cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the Charité - Universitätsmedizin Berlin, Berlin, Germany; Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany; DZHK (German Center for Cardiovascular Research), partner site Berlin, Germany
| | - Stefan Marc Botha
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität, Berlin, Germany; Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria 3084, Australia; Translational Obstetrics Group, The Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, Victoria 3084, Australia; Experimental and Clinical Research Center, a cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the Charité - Universitätsmedizin Berlin, Berlin, Germany; Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Clive M Gray
- Division of Molecular Biology and Human Genetics, Biomedical Research Institute, Stellenbosch University, Cape Town 7505, South Africa
| | - Daniela S Valdes
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität, Berlin, Germany; Experimental and Clinical Research Center, a cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the Charité - Universitätsmedizin Berlin, Berlin, Germany; Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Stephen Tong
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria 3084, Australia; Translational Obstetrics Group, The Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, Victoria 3084, Australia
| | - Tu'uhevaha J Kaitu'u-Lino
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria 3084, Australia; Translational Obstetrics Group, The Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, Victoria 3084, Australia
| | - Florian Herse
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität, Berlin, Germany; Experimental and Clinical Research Center, a cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the Charité - Universitätsmedizin Berlin, Berlin, Germany; Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Lina Bergman
- Department of Obstetrics and Gynaecology, Stellenbosch University, Cape Town 7505, South Africa; Department of Women's and Children's Health, Uppsala University, Uppsala 751 85, Sweden,; Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg 405 30, Sweden
| | - Catherine A Cluver
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria 3084, Australia; Translational Obstetrics Group, The Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, Victoria 3084, Australia; Department of Obstetrics and Gynaecology, Stellenbosch University, Cape Town 7505, South Africa
| | - Ralf Dechend
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität, Berlin, Germany; Experimental and Clinical Research Center, a cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the Charité - Universitätsmedizin Berlin, Berlin, Germany; Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany; DZHK (German Center for Cardiovascular Research), partner site Berlin, Germany; HELIOS Clinic, Department of Cardiology and Nephrology, Berlin, Germany
| | - Olivia Nonn
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität, Berlin, Germany; Experimental and Clinical Research Center, a cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the Charité - Universitätsmedizin Berlin, Berlin, Germany; Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany; DZHK (German Center for Cardiovascular Research), partner site Berlin, Germany; Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria.
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6
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Xie Y, Zhao F, Freitag N, Borowski S, Wang Y, Harms C, Pang PC, Desforges J, Wen T, Schwedhelm E, Singh M, Dechend R, Dell A, Haslam SM, Dveksler G, Garcia MG, Blois SM. Maternal-derived galectin-1 shapes the placenta niche through Sda terminal glycosylation: Implication for preeclampsia. PNAS Nexus 2023; 2:pgad247. [PMID: 37575671 PMCID: PMC10416815 DOI: 10.1093/pnasnexus/pgad247] [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: 04/14/2023] [Accepted: 07/20/2023] [Indexed: 08/15/2023]
Abstract
Placental abnormalities cause impaired fetal growth and poor pregnancy outcome (e.g. preeclampsia [PE]) with long-lasting consequences for the mother and offspring. The molecular dialogue between the maternal niche and the developing placenta is critical for the function of this organ. Galectin-1 (gal-1), a highly expressed glycan-binding protein at the maternal-fetal interface, orchestrates the maternal adaptation to pregnancy and placenta development. Down-regulation or deficiency of gal-1 during pregnancy is associated with the development of PE; however, the maternal- and placental-derived gal-1 contributions to the disease onset are largely unknown. We demonstrate that lack of gal-1 imposes a risk for PE development in a niche-specific manner, and this is accompanied by a placental dysfunction highly influenced by the absence of maternal-derived gal-1. Notably, differential placental glycosylation through the Sda-capped N-glycans dominates the invasive trophoblast capacity triggered by maternal-derived gal-1. Our findings show that gal-1 derived from the maternal niche is essential for healthy placenta development and indicate that impairment of the gal-1 signaling pathway within the maternal niche could be a molecular cause for maternal cardiovascular maladaptation during pregnancy.
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Affiliation(s)
- Yiran Xie
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Fangqi Zhao
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Nancy Freitag
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
- Experimental and Clinical Research Center (ECRC), a cooperation of the Max-Delbrück Center for Molecular Medicine (MDC) and Charité-Universitätsmedizin, 13125 Berlin, Germany
| | - Sophia Borowski
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
- Experimental and Clinical Research Center (ECRC), a cooperation of the Max-Delbrück Center for Molecular Medicine (MDC) and Charité-Universitätsmedizin, 13125 Berlin, Germany
| | - Yiru Wang
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Charlotte Harms
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Poh-Choo Pang
- Department of Life Sciences, Imperial College London, London SW7 2AZ, UK
| | - Juliette Desforges
- Department of Life Sciences, Imperial College London, London SW7 2AZ, UK
| | - Tianyu Wen
- Department of Life Sciences, Imperial College London, London SW7 2AZ, UK
| | - Edzard Schwedhelm
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf and German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, 20249 Hamburg, Germany
| | - Manvendra Singh
- Clinical Neuroscience, Max Planck Institute for Multidisciplinary Sciences, 37075 Göttingen, Germany
| | - Ralf Dechend
- Experimental and Clinical Research Center (ECRC), a cooperation of the Max-Delbrück Center for Molecular Medicine (MDC) and Charité-Universitätsmedizin, 13125 Berlin, Germany
- Department of Cardiology and Nephrology, HELIOS-Klinikum, 13125 Berlin, Germany
| | - Anne Dell
- Department of Life Sciences, Imperial College London, London SW7 2AZ, UK
| | - Stuart M Haslam
- Department of Life Sciences, Imperial College London, London SW7 2AZ, UK
| | - Gabriela Dveksler
- Department of Pathology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Mariana G Garcia
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Sandra M Blois
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
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7
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Campbell N, Strong L, Fang X, Border JJ, Herrock O, Turner T, Deer E, Amaral L, Dechend R, Roman RJ, LaMarca B. AT1-AA Infusion during Pregnancy Impairs CBF Autoregulation Postpartum. Int J Cerebrovasc Dis Stroke 2023; 6:154. [PMID: 37901747 PMCID: PMC10610033 DOI: 10.29011/2688-8734.100154] [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] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Preeclampsia (PE), new-onset hypertension during pregnancy alongside organ dysfunction, is a leading cause of morbidity and mortality for the mother and fetus. PE women have activated B cells that produce agonistic autoantibodies to the angiotensin II type 1 receptor (AT1-AA). AT1-AA impairs cerebral blood flow (CBF) autoregulation during pregnancy. Although AT1-AA often remains elevated up to 8 years postpartum, AT1-AA's effect on CBF autoregulation postpartum is unknown. This study examined whether elevated AT1-AA during pregnancy impairs CBF autoregulation postpartum and if this was augmented by infusion of AT1-AA postpartum. AT1-AA was infused into 12-week-old timed-pregnant Sprague Dawley rats beginning on gestational day 14. Uterine artery resistance index (UARI) was measured on gestational day 18 as a measure of endothelial dysfunction associated with PE. Dams were allowed to deliver. One group was given a second infusion of AT1-AA (50% perinatal dose mimicking levels observed in postpartum PE women) at 9 weeks postpartum. After postpartum week 10, mean arterial pressure (MAP) was measured in conscious rats and CBF autoregulation was measured by laser Doppler flowmetry. AT1-AA during pregnancy increased UARI (P<0.05). AT1-AA during pregnancy did not affect MAP postpartum but did impair CBF autoregulation postpartum. Infusion of AT1-AA postpartum significantly elevated blood pressure (P<0.01) but did not further impair CBF autoregulation. This study demonstrates that circulating AT1-AA during pregnancy causes impairment of CBF autoregulation well into the postpartum period indicating that elevated AT1-AA leads to long-term cerebrovascular consequences. Targeting AT1-AA may prevent cerebrovascular effects associated with PE during pregnancy and postpartum.
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Affiliation(s)
- Nathan Campbell
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Luke Strong
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Xing Fang
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Jane J Border
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Owen Herrock
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Ty Turner
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Evangeline Deer
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Lorena Amaral
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Ralf Dechend
- Charité, Campus Buch, Experimental and Clinical Research Center, HELIOS Clinic, Berlin-Buch, Germany
| | - Richard J Roman
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Babbette LaMarca
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, USA
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8
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Freise L, Behncke RY, Allerkamp HH, Sandermann TH, Chu NH, Funk EM, Hondrich LJ, Riedel A, Witzel C, Hansmeier NR, Danyel M, Gellhaus A, Dechend R, Hägerling R. Three-Dimensional Histological Characterization of the Placental Vasculature Using Light Sheet Microscopy. Biomolecules 2023; 13:1009. [PMID: 37371590 DOI: 10.3390/biom13061009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/20/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
The placenta is the first embryonic organ, representing the connection between the embryo and the mother, and is therefore necessary for the embryo's growth and survival. To meet the ever-growing need for nutrient and gas exchange, the maternal spiral arteries undergo extensive remodeling, thus increasing the uteroplacental blood flow by 16-fold. However, the insufficient remodeling of the spiral arteries can lead to severe pregnancy-associated disorders, including but not limited to pre-eclampsia. Insufficient endovascular trophoblast invasion plays a key role in the manifestation of pre-eclampsia; however, the underlying processes are complex and still unknown. Classical histopathology is based on two-dimensional section microscopy, which lacks a volumetric representation of the vascular remodeling process. To further characterize the uteroplacental vascularization, a detailed, non-destructive, and subcellular visualization is beneficial. In this study, we use light sheet microscopy for optical sectioning, thus establishing a method to obtain a three-dimensional visualization of the vascular system in the placenta. By introducing a volumetric visualization method of the placenta, we could establish a powerful tool to deeply investigate the heterogeneity of the spiral arteries during the remodeling process, evaluate the state-of-the-art treatment options, effects on vascularization, and, ultimately, reveal new insights into the underlying pathology of pre-eclampsia.
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Affiliation(s)
- Lennart Freise
- Research Group 'Lymphovascular Medicine and Translational 3D-Histopathology', Institute of Medical and Human Genetics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health, Charité - Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Rose Yinghan Behncke
- Research Group 'Lymphovascular Medicine and Translational 3D-Histopathology', Institute of Medical and Human Genetics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health, Charité - Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Hanna Helene Allerkamp
- Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
| | - Tim Henrik Sandermann
- Research Group 'Lymphovascular Medicine and Translational 3D-Histopathology', Institute of Medical and Human Genetics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health, Charité - Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Ngoc Hai Chu
- Research Group 'Lymphovascular Medicine and Translational 3D-Histopathology', Institute of Medical and Human Genetics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health, Charité - Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Eva Maria Funk
- Research Group 'Lymphovascular Medicine and Translational 3D-Histopathology', Institute of Medical and Human Genetics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health, Charité - Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Lukas Jonathan Hondrich
- Research Group 'Lymphovascular Medicine and Translational 3D-Histopathology', Institute of Medical and Human Genetics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health, Charité - Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Alina Riedel
- Department of Gynecology and Obstetrics, University Hospital Essen, 45147 Essen, Germany
| | - Christian Witzel
- Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Nils Rouven Hansmeier
- Research Group 'Lymphovascular Medicine and Translational 3D-Histopathology', Institute of Medical and Human Genetics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health, Charité - Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Augustenburger Platz 1, 13353 Berlin, Germany
- Research Group 'Development and Disease', Max Planck Institute for Molecular Genetics, Ihnestraße 63-73, 14195 Berlin, Germany
| | - Magdalena Danyel
- Research Group 'Lymphovascular Medicine and Translational 3D-Histopathology', Institute of Medical and Human Genetics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health, Charité - Universitätsmedizin Berlin, BIH Academy, Clinician Scientist Program, Charitéplatz 1, 10117 Berlin, Germany
| | - Alexandra Gellhaus
- Department of Gynecology and Obstetrics, University Hospital Essen, 45147 Essen, Germany
| | - Ralf Dechend
- Experimental and Clinical Research Center (ECRC), a Cooperation of Charité - Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine (MDC), Lindenbergerweg 80, 13125 Berlin, Germany
- HELIOS Klinikum, 13125 Berlin, Germany
| | - René Hägerling
- Research Group 'Lymphovascular Medicine and Translational 3D-Histopathology', Institute of Medical and Human Genetics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health, Charité - Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Augustenburger Platz 1, 13353 Berlin, Germany
- Research Group 'Development and Disease', Max Planck Institute for Molecular Genetics, Ihnestraße 63-73, 14195 Berlin, Germany
- Berlin Institute of Health, Charité - Universitätsmedizin Berlin, BIH Academy, Clinician Scientist Program, Charitéplatz 1, 10117 Berlin, Germany
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9
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Cabral-Marques O, Moll G, Catar R, Preuß B, Bankamp L, Pecher AC, Henes J, Klein R, Kamalanathan AS, Akbarzadeh R, van Oostveen W, Hohberger B, Endres M, Koolmoes B, Levarht N, Postma R, van Duinen V, van Zonneveld AJ, de Vries-Bouwstra J, Fehres C, Tran F, do Vale FYN, da Silva Souza KB, Filgueiras IS, Schimke LF, Baiocchi GC, de Miranda GC, da Fonseca DLM, Freire PP, Hackel AM, Grasshoff H, Stähle A, Müller A, Dechend R, Yu X, Petersen F, Sotzny F, Sakmar TP, Ochs HD, Schulze-Forster K, Heidecke H, Scheibenbogen C, Shoenfeld Y, Riemekasten G. Autoantibodies targeting G protein-coupled receptors: An evolving history in autoimmunity. Report of the 4th international symposium. Autoimmun Rev 2023; 22:103310. [PMID: 36906052 DOI: 10.1016/j.autrev.2023.103310] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/02/2023] [Indexed: 03/11/2023]
Abstract
G protein-coupled receptors (GPCR) are involved in various physiological and pathophysiological processes. Functional autoantibodies targeting GPCRs have been associated with multiple disease manifestations in this context. Here we summarize and discuss the relevant findings and concepts presented in the biennial International Meeting on autoantibodies targeting GPCRs (the 4th Symposium), held in Lübeck, Germany, 15-16 September 2022. The symposium focused on the current knowledge of these autoantibodies' role in various diseases, such as cardiovascular, renal, infectious (COVID-19), and autoimmune diseases (e.g., systemic sclerosis and systemic lupus erythematosus). Beyond their association with disease phenotypes, intense research related to the mechanistic action of these autoantibodies on immune regulation and pathogenesis has been developed, underscoring the role of autoantibodies targeting GPCRs on disease outcomes and etiopathogenesis. The observation repeatedly highlighted that autoantibodies targeting GPCRs could also be present in healthy individuals, suggesting that anti-GPCR autoantibodies play a physiologic role in modeling the course of diseases. Since numerous therapies targeting GPCRs have been developed, including small molecules and monoclonal antibodies designed for treating cancer, infections, metabolic disorders, or inflammatory conditions, anti-GPCR autoantibodies themselves can serve as therapeutic targets to reduce patients' morbidity and mortality, representing a new area for the development of novel therapeutic interventions.
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Affiliation(s)
- Otávio Cabral-Marques
- Department of Medicine, Division of Molecular Medicine, University of São Paulo School of Medicine, São Paulo, Brazil; Laboratory of Medical Investigation 29, University of São Paulo School of Medicine, São Paulo, Brazil; Department of Pharmacy and Postgraduate Program of Health and Science, Federal University of Rio Grande do Norte, Natal, Brazil; Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil; Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil; Interunit Postgraduate Program on Bioinformatics, Institute of Mathematics and Statistics (IME), University of Sao Paulo (USP), Sao Paulo, Brazil.
| | - Guido Moll
- Department of Nephrology and Internal Intensive Care Medicine, Charité University Hospital, Berlin, Germany; BIH Center for Regenerative Therapies (BCRT) and Berlin-Brandenburg School for Regenerative Therapies (BSRT), all Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Rusan Catar
- Department of Nephrology and Internal Intensive Care Medicine, Charité University Hospital, Berlin, Germany
| | - Beate Preuß
- Department of Internal Medicine II, University of Tübingen, Tübingen, Germany
| | - Lukas Bankamp
- Department of Internal Medicine II, University of Tübingen, Tübingen, Germany
| | - Ann-Christin Pecher
- Department of Internal Medicine II, University of Tübingen, Tübingen, Germany
| | - Joerg Henes
- Department of Internal Medicine II, University of Tübingen, Tübingen, Germany
| | - Reinhild Klein
- Department of Internal Medicine II, University of Tübingen, Tübingen, Germany
| | - A S Kamalanathan
- Centre for BioSeparation Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Reza Akbarzadeh
- Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany
| | - Wieke van Oostveen
- Leiden University Medical Center (LUMC), Department of Rheumatology, Leiden, the Netherlands
| | - Bettina Hohberger
- Department of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Endres
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Department of Neurology with Experimental Neurology, Berlin, Germany.; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, Berlin, Germany; Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Cluster of Excellence, Berlin, Germany; Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Stroke Research Berlin, Berlin, Germany; German Center for Neurodegenerative Diseases (DZNE), Partner Site Berlin, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Bryan Koolmoes
- Leiden University Medical Center (LUMC), Department of Rheumatology, Leiden, the Netherlands
| | - Nivine Levarht
- Leiden University Medical Center (LUMC), Department of Rheumatology, Leiden, the Netherlands
| | - Rudmer Postma
- LUMC, Department of Internal Medicine (Nephrology), Einthoven Laboratory for Vascular and Regenerative Medicine, Leiden, the Netherlands
| | - Vincent van Duinen
- LUMC, Department of Internal Medicine (Nephrology), Einthoven Laboratory for Vascular and Regenerative Medicine, Leiden, the Netherlands
| | - Anton Jan van Zonneveld
- LUMC, Department of Internal Medicine (Nephrology), Einthoven Laboratory for Vascular and Regenerative Medicine, Leiden, the Netherlands
| | - Jeska de Vries-Bouwstra
- Leiden University Medical Center (LUMC), Department of Rheumatology, Leiden, the Netherlands
| | - Cynthia Fehres
- Leiden University Medical Center (LUMC), Department of Rheumatology, Leiden, the Netherlands
| | - Florian Tran
- Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany
| | - Fernando Yuri Nery do Vale
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | | | - Igor Salerno Filgueiras
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Lena F Schimke
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Gabriela Crispim Baiocchi
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Gustavo Cabral de Miranda
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Dennyson Leandro Mathias da Fonseca
- Interunit Postgraduate Program on Bioinformatics, Institute of Mathematics and Statistics (IME), University of Sao Paulo (USP), Sao Paulo, Brazil
| | - Paula Paccielli Freire
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Alexander M Hackel
- Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany
| | - Hanna Grasshoff
- Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany
| | - Anja Stähle
- Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany
| | - Antje Müller
- Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany
| | - Ralf Dechend
- Experimental and Clinical Research Center, A collaboration of Max Delbruck Center for Molecular Medicine and Charité Universitätsmedizin, and HELIOS Clinic, Department of Cardiology and Nephrology, Berlin 13125, Germany
| | - Xinhua Yu
- Priority Area Chronic Lung Diseases, Research Center Borstel (RCB), Member of the German Center for Lung Research (DZL), Borstel, Germany
| | - Frank Petersen
- Priority Area Chronic Lung Diseases, Research Center Borstel (RCB), Member of the German Center for Lung Research (DZL), Borstel, Germany
| | - Franziska Sotzny
- Institute for Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
| | - Thomas P Sakmar
- Laboratory of Chemical Biology and Signal Transduction, The Rockefeller University, New York, NY, USA
| | - Hans D Ochs
- University of Washington School of Medicine and Seattle Children's Research Institute, Seattle, WA, USA
| | | | | | - Carmen Scheibenbogen
- Institute for Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Gabriela Riemekasten
- Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany.
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10
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Herrock OT, Deer E, Amaral LM, Campbell N, Lemon J, Ingram N, Cornelius DC, Turner TW, Fitzgerald S, Ibrahim T, Dechend R, Wallukat G, LaMarca B. B2 cells contribute to hypertension and natural killer cell activation possibly via AT1-AA in response to placental ischemia. Am J Physiol Renal Physiol 2023; 324:F179-F192. [PMID: 36417275 PMCID: PMC9844978 DOI: 10.1152/ajprenal.00190.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/31/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022] Open
Abstract
Preeclampsia, new onset hypertension during pregnancy, is associated with activated T helper cells (Th) and B cells secreting agonistic autoantibodies against the angiotensin II type 1 receptor (AT1-AA). The reduced uterine perfusion pressure (RUPP) model of placental ischemia recapitulates these characteristics. We have shown that Th-B cell communication contributes to AT1-AA and symptoms of preeclampsia in the RUPP rat. B2 cells are classical B cells that communicate with Th cells and are then transformed into memory B cells. We hypothesize that B2 cells cause hypertension, natural killer (NK) cell activation, and complement activation during pregnancy through the production of AT1-AA. To test this hypothesis, total splenic B cells and B2 cells were isolated from normal pregnant (NP) or RUPP rats on gestational day (GD)19 and adoptively transferred into GD12 NP rats. A group of recipient rats was treated with a specific inhibitor peptide of AT1-AA. On GD19, mean arterial pressure was measured, tissues were collected, activated NK cells were measured by flow cytometry, and AT1-AA was measured by cardiomyocyte assay. NP recipients of RUPP B cells or RUPP B2 cells had increased mean arterial pressure, AT1-AA, and circulating activated NK cells compared with recipients of NP B cells. Hypertension in NP recipients of RUPP B cells or RUPP B2 was attenuated with AT1-AA blockade. This study demonstrates that B cells and B2 cells from RUPP rats cause hypertension and increased AT1-AA and NK cell activation in response to placental ischemia during pregnancy.NEW & NOTEWORTHY This study demonstrates that placental ischemia-stimulated B2 cells induce hypertension and circulating natural killer cell activation and angiotensin II type 1 receptor production in normal pregnant rats.
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Affiliation(s)
- Owen T Herrock
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Evangeline Deer
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Lorena M Amaral
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Nathan Campbell
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - James Lemon
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Nicole Ingram
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Denise C Cornelius
- Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Ty W Turner
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Sarah Fitzgerald
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Tarek Ibrahim
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Ralf Dechend
- Experimental and Clinical Research Center, HELIOS Clinic, Max-Delbrück-Centrum für Molekulare Medizin, Berlin, Germany
| | - Gerd Wallukat
- Experimental and Clinical Research Center, HELIOS Clinic, Max-Delbrück-Centrum für Molekulare Medizin, Berlin, Germany
| | - Babbette LaMarca
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi
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11
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Linge LL, Sugulle M, Wallukat G, Dechend R, Staff AC. Circulating angiotensin II type I receptor - autoantibodies in diabetic pregnancies. J Reprod Immunol 2023; 155:103777. [PMID: 36495655 DOI: 10.1016/j.jri.2022.103777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 10/25/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022]
Abstract
Pregnant women with either pre-existing or gestational diabetes mellitus are at increased risk of preeclampsia as well as future cardiovascular disease. The renin-angiotensin system is dysregulated in both diabetes mellitus and preeclampsia. In preeclampsia, maternal levels of circulating agonistic autoantibodies against the angiotensin II Type I receptor (AT1-AAs) are increased. Circulating AT1-AAs are thought to contribute to both the pathophysiology of preeclampsia and the increased risk of future cardiovascular disease. Studies exploring AT1-AA in diabetes outside pregnancy suggest their potential for both metabolic and cardiovascular pathogenicity. No studies have investigated AT1-AAs in diabetic pregnancies. We hypothesized elevated maternal circulating AT1-AA levels in pregnancies complicated by any type of diabetes mellitus. Third-trimester maternal serum from 39 women (controls: n = 10; type 1 diabetes: n = 9; type 2 diabetes: n = 10; gestational diabetes=10) were analyzed for AT1-AA using an established bioassay method. Circulating AT1-AAs were present in 70% (7/10) of the controls and 83% (24/29) of the diabetes group (P = 0.399). Presence of AT1-AA was correlated to hsCRP levels (P = 0.036), but neither with maternal circulating angiogenic factors (soluble fms-like tyrosine kinase-1 and placental growth factor), nor with maternal or fetal characteristics indicative of metabolic disease or placental dysfunction. Our study is the first to demonstrate presence of circulating AT1-AAs in pregnant women with any type of diabetes. Our findings suggest AT1-AAs presence in pregnancy independently of placental dysfunction, nuancing the current view on their pathogenicity. Whether AT1-AAs per se contribute to increased risk of adverse pregnancy outcomes and future cardiovascular disease remains currently unanswered.
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Affiliation(s)
- Lydia Lande Linge
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Division of Gynaecology and Obstetrics, Oslo University Hospital, Oslo, Norway
| | - Meryam Sugulle
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Division of Gynaecology and Obstetrics, Oslo University Hospital, Oslo, Norway.
| | - Gerd Wallukat
- Experimental and Clinical Research Center, a joint cooperation between the Max-Delbrück Center for Molecular Medicine in the Helmholtz Association and the Charité Medical Faculty, Berlin, Germany
| | - Ralf Dechend
- Experimental and Clinical Research Center, a joint cooperation between the Max-Delbrück Center for Molecular Medicine in the Helmholtz Association and the Charité Medical Faculty, Berlin, Germany; Department of Cardiology and Nephrology, HELIOS Klinikum Berlin, Germany
| | - Anne Cathrine Staff
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Division of Gynaecology and Obstetrics, Oslo University Hospital, Oslo, Norway
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12
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Zweck E, Karschnia M, Scheiber D, Heidecke H, Dechend R, Barthuber C, Kaufmann S, Kelm M, Roden M, Westenfeld R, Szendrödi J, Boege F. Receptor autoantibodies: Associations with cardiac markers, histology, and function in human non-ischaemic heart failure. ESC Heart Fail 2023; 10:1258-1269. [PMID: 36717981 PMCID: PMC10053254 DOI: 10.1002/ehf2.14293] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/17/2022] [Accepted: 11/08/2022] [Indexed: 02/01/2023] Open
Abstract
AIMS A causal link between non-ischaemic heart failure (HF) and humoral autoimmunity against G-protein-coupled receptors (GPCR) remains unclear except for Chagas' cardiomyopathy. Uncertainty arises from ambiguous reports on incidences of GPCR autoantibodies, spurious correlations of autoantibody levels with disease activity, and lack of standardization and validation of measuring procedures for putatively cardio-pathogenic GPCR autoantibodies. Here, we use validated and certified immune assays presenting native receptors as binding targets. We compared candidate GPCR autoantibody species between HF patients and healthy controls and tested associations of serum autoantibody levels with serological, haemodynamic, metabolic, and functional parameters in HF. METHODS Ninety-five non-ischaemic HF patients undergoing transcatheter endomyocardial biopsy and 60 healthy controls were included. GPCR autoantibodies were determined in serum by IgG binding to native receptors or a cyclic peptide (for β1AR autoantibodies). In patients, cardiac function, volumes, and myocardial structural properties were assessed by cardiac magnetic resonance imaging; right heart catheterization served for determination of cardiac haemodynamics; endomyocardial biopsies were used for histological assessment of cardiomyopathy and determination of cardiac mitochondrial oxidative function by high-resolution respirometry. RESULTS Autoantibodies against β1 adrenergic (β1 AR) , M5-muscarinic (M5AR), and angiotensin II type 2 receptors (AT2R) were increased in HF (all P < 0.001). Autoantibodies against α1 -adrenergic (α1 AR) and angiotensin II type 1 receptors (AT1R) were decreased in HF (all P < 0.001). Correlation of alterations of GPCR autoantibodies with markers of cardiac or systemic inflammation or cardiac damage, haemodynamics, myocardial histology, or left ventricular inflammation (judged by T2 mapping) were weak, even when corrected for total IgG. β1 AR autoantibodies were related inversely to markers of left ventricular fibrosis indicated by T1 mapping (r = -0.362, P < 0.05) and global longitudinal strain (r = -0.323, P < 0.05). AT2R autoantibodies were associated with improved myocardial mitochondrial coupling as measured by high-resolution respirometry in myocardial biopsies (r = -0.352, P < 0.05). In insulin-resistant HF patients, AT2R autoantibodies were decreased (r = -.240, P < 0.05), and AT1R autoantibodies were increased (r = 0.212, P < 0.05). CONCLUSIONS GPCR autoantibodies are markedly altered in HF. However, they are correlated poorly or even inversely to haemodynamic, metabolic, and functional markers of disease severity, myocardial histology, and myocardial mitochondrial efficiency. These observations do not hint towards a specific cardio-pathogenic role of GPCR autoantibodies and suggest that further investigations are required before specific therapies directed at GPCR autoantibodies can be clinically tested in non-ischaemic HF.
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Affiliation(s)
- Elric Zweck
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany.,Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Maximilian Karschnia
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany.,Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Daniel Scheiber
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany.,Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | | | - Ralf Dechend
- Experimental and Clinical Research Center, University and Max Delbrück Center for Molecular Medicine; Departments of Cardiology and Nephrology, Helios Clinic Berlin-Buch, Berlin, Germany
| | - Carmen Barthuber
- Central Institute for Clinical Chemistry and Laboratory Diagnostics, Medical Faculty, Heinrich Heine University and University Hospital, Düsseldorf, Germany
| | - Sina Kaufmann
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Malte Kelm
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.,Cardiovascular Research Institute Düsseldorf, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany.,Cardiovascular Research Institute Düsseldorf, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.,Division of Endocrinology and Diabetology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Ralf Westenfeld
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Julia Szendrödi
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany.,Division of Endocrinology and Diabetology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Fritz Boege
- Central Institute for Clinical Chemistry and Laboratory Diagnostics, Medical Faculty, Heinrich Heine University and University Hospital, Düsseldorf, Germany
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13
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Kedziora SM, Obermayer B, Sugulle M, Herse F, Kräker K, Haase N, Langmia IM, Müller DN, Staff AC, Beule D, Dechend R. Placental Transcriptome Profiling in Subtypes of Diabetic Pregnancies Is Strongly Confounded by Fetal Sex. Int J Mol Sci 2022; 23:ijms232315388. [PMID: 36499721 PMCID: PMC9740420 DOI: 10.3390/ijms232315388] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
The placenta is a temporary organ with a unique structure and function to ensure healthy fetal development. Placental dysfunction is involved in pre-eclampsia (PE), fetal growth restriction, preterm birth, and gestational diabetes mellitus (GDM). A diabetic state affects maternal and fetal health and may lead to functional alterations of placental metabolism, inflammation, hypoxia, and weight, amplifying the fetal stress. The placental molecular adaptations to the diabetic environment and the adaptive spatio-temporal consequences to elevated glucose or insulin are largely unknown (2). We aimed to identify gene expression signatures related to the diabetic placental pathology of placentas from women with diabetes mellitus. Human placenta samples (n = 77) consisting of healthy controls, women with either gestational diabetes mellitus (GDM), type 1 or type 2 diabetes, and women with GDM, type 1 or type 2 diabetes and superimposed PE were collected. Interestingly, gene expression differences quantified by total RNA sequencing were mainly driven by fetal sex rather than clinical diagnosis. Association of the principal components with a full set of clinical patient data identified fetal sex as the single main explanatory variable. Accordingly, placentas complicated by type 1 and type 2 diabetes showed only few differentially expressed genes, while possible effects of GDM and diabetic pregnancy complicated by PE were not identifiable in this cohort. We conclude that fetal sex has a prominent effect on the placental transcriptome, dominating and confounding gene expression signatures resulting from diabetes mellitus in settings of well-controlled diabetic disease. Our results support the notion of placenta as a sexual dimorphic organ.
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Affiliation(s)
- Sarah M. Kedziora
- Experimental and Clinical Research Center (ECRC), a Joint Cooperation between the Charité—Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine, 13125 Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), 13125 Berlin, Germany
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Berlin Institute of Health, 10178 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site, 10785 Berlin, Germany
| | - Benedikt Obermayer
- Berlin Institute of Health, Charité—Universitätsmedizin Berlin, Core Unit Bioinformatics, 10117 Berlin, Germany
| | - Meryam Sugulle
- Faculty of Medicine, University of Oslo, 0372 Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, 0424 Oslo, Norway
| | - Florian Herse
- Experimental and Clinical Research Center (ECRC), a Joint Cooperation between the Charité—Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine, 13125 Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), 13125 Berlin, Germany
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Berlin Institute of Health, 10178 Berlin, Germany
| | - Kristin Kräker
- Experimental and Clinical Research Center (ECRC), a Joint Cooperation between the Charité—Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine, 13125 Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), 13125 Berlin, Germany
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Berlin Institute of Health, 10178 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site, 10785 Berlin, Germany
| | - Nadine Haase
- Experimental and Clinical Research Center (ECRC), a Joint Cooperation between the Charité—Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine, 13125 Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), 13125 Berlin, Germany
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Berlin Institute of Health, 10178 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site, 10785 Berlin, Germany
| | - Immaculate M. Langmia
- Experimental and Clinical Research Center (ECRC), a Joint Cooperation between the Charité—Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine, 13125 Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), 13125 Berlin, Germany
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Berlin Institute of Health, 10178 Berlin, Germany
| | - Dominik N. Müller
- Experimental and Clinical Research Center (ECRC), a Joint Cooperation between the Charité—Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine, 13125 Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), 13125 Berlin, Germany
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Berlin Institute of Health, 10178 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site, 10785 Berlin, Germany
| | - Anne Cathrine Staff
- Faculty of Medicine, University of Oslo, 0372 Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, 0424 Oslo, Norway
| | - Dieter Beule
- Berlin Institute of Health, Charité—Universitätsmedizin Berlin, Core Unit Bioinformatics, 10117 Berlin, Germany
| | - Ralf Dechend
- Experimental and Clinical Research Center (ECRC), a Joint Cooperation between the Charité—Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine, 13125 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site, 10785 Berlin, Germany
- HELIOS Clinic, Department of Cardiology and Nephrology, 13125 Berlin, Germany
- Correspondence: ; Tel.: +49-30-4505-40301
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14
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Dechend R, Delles C. Endothelin antagonists and the quest for a new therapeutic option in resistant hypertension. Lancet 2022; 400:1900-1901. [PMID: 36356630 DOI: 10.1016/s0140-6736(22)02181-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 10/28/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Ralf Dechend
- Experimental and Clinical Research Center, University and Max Delbrück Center for Molecular Medicine, Berlin 13125, Germany; Departments of Cardiology and Nephrology, Helios Clinic Berlin-Buch, Germany.
| | - Christian Delles
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
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15
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Dechend R. Diagnostik, Therapie und die Bedeutung der Lebensqualität von Patienten mit chronischem Koronarsyndrom. MMW Fortschr Med 2022; 164:11-17. [PMID: 35449487 PMCID: PMC9023112 DOI: 10.1007/s15006-022-0959-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Hintergrund: Das Krankheitsbild der chronischen koronaren Herzkrankheit hat sich in den vergangenen Jahren erheblich gewandelt. Davon zeugt nicht zuletzt die Neudefinition der Erkrankung als chronisches Koronarsyndrom (chronic coronary syndrome, CCS) im Jahr 2019. Vor dem Hintergrund dieser Entwicklung war das primäre Ziel der Versorgungsstudie ALTHEA, einen Einblick in die aktuelle Versorgung von Patienten mit CCS und stabiler Angina pectoris (AP) in der hausärztlichen Praxis in Deutschland zu erhalten. Methode: ALTHEA ist eine bundesweit durchgeführte Querschnittstudie unter Verwendung eines strukturierten Fragebogens bestehend aus geschlossenen Single- bzw. Multiple-Choice-Fragen. Der Fragebogen umfasste 10 Fragen zu den Bereichen Diagnostik, symptomatische Therapie und Lebensqualität von Patienten mit Verdacht auf bzw. mit diagnostiziertem CCS und stabiler AP. Die Befragung richtete sich an Hausärzte. Ergebnisse: Die Befragung fand von April bis September 2021 statt. Angesprochen wurden bundesweit 1.050 Hausärzte, mit dem Ziel eine möglichst repräsentative Stichprobe zu erhalten. Von diesen haben 1.021 teilgenommen. Die Befragten gaben mehrheitlich an, bei Verdacht auf CCS eine apparative Diagnostik eigenständig durchzuführen, zu einem hohen Anteil einschließlich eines Belastungs-EKGs. Hinsichtlich des Therapieziels gewichtete die Mehrheit der Befragten eine Verbesserung der Lebensqualität höher als eine Prognoseverbesserung. Die überwiegende Mehrheit der befragten Hausärzte gab zudem an, bei symptomatischen Patienten mit Verdacht auf CCS eigenständig eine symptomatische Therapie einzuleiten und deren Erfolg im weiteren Krankheitsverlauf zu kontrollieren. Bei der Bewertung der verfügbaren Antianginosa zeigten sich Präferenzen in Bezug auf Wirksamkeit (Betablocker), Verträglichkeit (Ranolazin) und Einfluss auf die Lebensqualität (Ranolazin). Schlussfolgerungen: Die Versorgungsstudie macht deutlich, dass sich Hausärzte in der gegenwärtigen Versorgung von Patienten mit Verdacht auf CCS und stabiler AP als wichtige Lotsen der Kardiologie verstehen. Sie übernehmen grundlegende Aufgaben in Diagnostik und symptomatischer Therapie, die zum Teil eine deutliche Schnittmenge mit dem Aufgabenbereich der Kardiologen bilden. Demnach zeigt die Studie bei der Versorgung dieser Patienten eine enge Verzahnung von Allgemeinmedizin und Kardiologie. Schlüsselwörter: Angina pectoris, chronisches Koronarsyndrom, koronare Herzkrankheit, Diagnostik, symptomatische Therapie, Lebensqualität, hausärztliche Versorgung Eingereicht am 10.1.2022 - Revision akzeptiert am 15.3.2022
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16
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Cabral-Marques O, Halpert G, Schimke LF, Ostrinski Y, Vojdani A, Baiocchi GC, Freire PP, Filgueiras IS, Zyskind I, Lattin MT, Tran F, Schreiber S, Marques AHC, Plaça DR, Fonseca DLM, Humrich JY, Müller A, Giil LM, Graßhoff H, Schumann A, Hackel A, Junker J, Meyer C, Ochs HD, Lavi YB, Scheibenbogen C, Dechend R, Jurisica I, Schulze-Forster K, Silverberg JI, Amital H, Zimmerman J, Heidecke H, Rosenberg AZ, Riemekasten G, Shoenfeld Y. Autoantibodies targeting GPCRs and RAS-related molecules associate with COVID-19 severity. Nat Commun 2022; 13:1220. [PMID: 35264564 PMCID: PMC8907309 DOI: 10.1038/s41467-022-28905-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 02/16/2022] [Indexed: 12/27/2022] Open
Abstract
COVID-19 shares the feature of autoantibody production with systemic autoimmune diseases. In order to understand the role of these immune globulins in the pathogenesis of the disease, it is important to explore the autoantibody spectra. Here we show, by a cross-sectional study of 246 individuals, that autoantibodies targeting G protein-coupled receptors (GPCR) and RAS-related molecules associate with the clinical severity of COVID-19. Patients with moderate and severe disease are characterized by higher autoantibody levels than healthy controls and those with mild COVID-19 disease. Among the anti-GPCR autoantibodies, machine learning classification identifies the chemokine receptor CXCR3 and the RAS-related molecule AGTR1 as targets for antibodies with the strongest association to disease severity. Besides antibody levels, autoantibody network signatures are also changing in patients with intermediate or high disease severity. Although our current and previous studies identify anti-GPCR antibodies as natural components of human biology, their production is deregulated in COVID-19 and their level and pattern alterations might predict COVID-19 disease severity.
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Affiliation(s)
- Otavio Cabral-Marques
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil.
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil.
- Network of Immunity in Infection, Malignancy, and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Sao Paulo, Brazil.
| | - Gilad Halpert
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
- Saint Petersburg State University, Saint-Petersburg, Russia
| | - Lena F Schimke
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Yuri Ostrinski
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
- Saint Petersburg State University, Saint-Petersburg, Russia
- Ariel University, Ariel, Israel
| | - Aristo Vojdani
- Department of Immunology, Immunosciences Laboratory, Inc., Los Angeles, CA, United States
- Cyrex Laboratories, LLC 2602S. 24th St., Phoenix, AZ, 85034, USA
| | - Gabriela Crispim Baiocchi
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Paula Paccielli Freire
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Igor Salerno Filgueiras
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Israel Zyskind
- Department of Pediatrics, NYU Langone Medical Center, New York, NY, USA
- Maimonides Medical Center, Brooklyn, NY, USA
| | - Miriam T Lattin
- Department of Biology, Yeshiva University, Manhatten, NY, USA
| | - Florian Tran
- Department of Internal Medicine I, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Stefan Schreiber
- Department of Internal Medicine I, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Alexandre H C Marques
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Desirée Rodrigues Plaça
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Dennyson Leandro M Fonseca
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Jens Y Humrich
- Department of Rheumatology, University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Antje Müller
- Department of Rheumatology, University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Lasse M Giil
- Department of Internal Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Hanna Graßhoff
- Department of Rheumatology, University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Anja Schumann
- Department of Rheumatology, University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Alexander Hackel
- Department of Rheumatology, University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Juliane Junker
- CellTrend Gesellschaft mit beschränkter Haftung (GmbH), Luckenwalde, Germany
| | - Carlotta Meyer
- CellTrend Gesellschaft mit beschränkter Haftung (GmbH), Luckenwalde, Germany
| | - Hans D Ochs
- Department of Pediatrics, University of Washington School of Medicine, and Seattle Children's Research Institute, Seattle, WA, USA
| | - Yael Bublil Lavi
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Carmen Scheibenbogen
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ralf Dechend
- Experimental and Clinical Research Center, a collaboration of Max Delbruck Center for Molecular Medicine and Charité Universitätsmedizin, and HELIOS Clinic, Department of Cardiology and Nephrology, Berlin, 13125, Germany
| | - Igor Jurisica
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, UHN; Data Science Discovery Centre, Krembil Research Institute, UHN, Departments of Medical Biophysics and Computer Science, University of Toronto, Toronto, Canada
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Kai Schulze-Forster
- CellTrend Gesellschaft mit beschränkter Haftung (GmbH), Luckenwalde, Germany
| | - Jonathan I Silverberg
- School of Medicine and Health Sciences, George Washington University, Washington, DC, USA
| | - Howard Amital
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel
| | | | - Harry Heidecke
- CellTrend Gesellschaft mit beschränkter Haftung (GmbH), Luckenwalde, Germany
| | - Avi Z Rosenberg
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Gabriela Riemekasten
- Department of Rheumatology, University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany.
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.
- Saint Petersburg State University, Saint-Petersburg, Russia.
- Ariel University, Ariel, Israel.
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17
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Reeve KE, Deer E, Amaral LM, Cornelius DC, Herrock O, Harmon AC, Campbell N, Fitzgerald S, Ibrahim T, Wallukat G, Dechend R, LaMarca B. Placental CD4 + T cells from preeclamptic patients cause autoantibodies to the angiotensin II type I receptor and hypertension in a pregnant rat model of preeclampsia. Explor Med 2022; 3:99-111. [PMID: 37645383 PMCID: PMC10465114 DOI: 10.37349/emed.2022.00077] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/09/2021] [Indexed: 08/31/2023] Open
Abstract
Preeclampsia (PE) is a hypertensive disorder of pregnancy associated with activated CD4+ T cells and autoantibodies to angiotensin II type 1 receptor (AT1-AA). We have previously shown that CD4+ T cells isolated from women with PE cause hypertension, increased tumor necrosis factor alpha (TNF-α), endothelin-1, and soluble fms-like tyrosine kinase-1 (sFlt-1) when injected into pregnant nude-athymic rats compared to CD4+ T cells from normal pregnant (NP) women. However, the role of PE CD4+ T cells to cause AT1-AA as a mechanism of hypertension is not known. Aim: Our goal was to determine if PE CD4+ T cells stimulate AT1-AA in pregnant nude-athymic rats. CD4+ T cells were isolated from human NP and PE placentasand injected into nude-athymic rats on gestational day (GD) 12. In order to examine the role of the PE CD4+ T cells to stimulate B cell secretion of AT1-AA, a subset of the rats receiving PE CD4+ T cells were treated with rituximab on GD 14 or anti-CD40 ligand (anti-CD40L) on GD 12. On GD 19, mean arterial pressure (MAP) and tissues were obtained MAP [114 ± 1 mmHg (n = 9)] and AT1-AA [19.8 ± 0.9 beats per minute (bpm, n = 4)] were increased in NP nude + PE CD4+ T cells compared to NP nude + NP CD4+ T cells [98 ± 2 mmHg (n = 7, P < 0.05) and 1.3 ± 0.9 bpm (n = 5, P < 0.05)]. Rituximab (103 ± 2 mmHg, n = 3, P < 0.05) and anti-CD40L (102 ± 1 mmHg, n = 3, P < 0.05) lowered MAP compared to NP nude + PE CD4+ T cells. Circulating a proliferation-inducing ligand (APRIL) and placental angiotensin-converting enzyme 2 (ACE-2) activity was increased in response to PE CD4+ T cells. These results show that placental CD4+ T cells play an important role in the pathophysiology of PE, by activating B cells secreting AT1-AA to cause hypertension during pregnancy.
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Affiliation(s)
- Kristin E. Reeve
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Evangeline Deer
- Department of Pharmacology, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Lorena M. Amaral
- Department of Pharmacology, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Denise C. Cornelius
- Department of Pharmacology, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Owen Herrock
- Department of Pharmacology, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Ashlyn C. Harmon
- Department of Pharmacology, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Nathan Campbell
- Department of Pharmacology, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Sarah Fitzgerald
- Department of Pharmacology, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Tarek Ibrahim
- Department of Pharmacology, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Gerd Wallukat
- Experimental and Clinical Research Center, Max-Delbrück-Centrum für Molekulare Medizin, 13092 Berlin, Germany
| | - Ralf Dechend
- Experimental and Clinical Research Center, Max-Delbrück-Centrum für Molekulare Medizin, 13092 Berlin, Germany
| | - Babbette LaMarca
- Department of Pharmacology, University of Mississippi Medical Center, Jackson, MS 39216, USA
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18
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Markó L, Dörr A, Linz P, van den Meiracker AH, Garrelds IM, Kuehne T, Dechend R, Danser AHJ, Flörcken A, Müller DN. Effect of Sunitinib Treatment on Skin Sodium Accumulation in Patients With Renal Cancer: a Pilot Study. Hypertension 2022; 79:e103-e105. [PMID: 35189705 DOI: 10.1161/hypertensionaha.122.19079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Lajos Markó
- Experimental and Clinical Research Center, a cooperation of Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany (L.M., R.D., D.N.M.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (L.M., D.M.N.).,Berlin Institute of Health (BIH), Germany (L.M., R.D., D.N.M.).,Charité - Universitätsmedizin Berlin, Germany (L.M., R.D., D.N.M.)
| | - Anne Dörr
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Berlin (A.D., A.F.)
| | - Peter Linz
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg, Germany. (P.L.).,Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Germany. (P.L.)
| | - Anton H van den Meiracker
- Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands (A.H.v.d.M., I.M.G., A.H.J.D.)
| | - Ingrid M Garrelds
- Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands (A.H.v.d.M., I.M.G., A.H.J.D.)
| | - Titus Kuehne
- Institute for Cardiovascular Computer-assisted Medicine, Charité - Universitätsmedizin Berlin, Germany (T.K.).,German Heart Center Berlin, Germany (T.K.)
| | - Ralf Dechend
- Experimental and Clinical Research Center, a cooperation of Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany (L.M., R.D., D.N.M.).,Berlin Institute of Health (BIH), Germany (L.M., R.D., D.N.M.).,Charité - Universitätsmedizin Berlin, Germany (L.M., R.D., D.N.M.).,Helios Clinic Berlin-Buch, Germany (R.D.)
| | - A H Jan Danser
- Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands (A.H.v.d.M., I.M.G., A.H.J.D.)
| | - Anne Flörcken
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Berlin (A.D., A.F.).,German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.F.)
| | - Dominik N Müller
- Experimental and Clinical Research Center, a cooperation of Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany (L.M., R.D., D.N.M.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (L.M., D.M.N.).,Berlin Institute of Health (BIH), Germany (L.M., R.D., D.N.M.).,Charité - Universitätsmedizin Berlin, Germany (L.M., R.D., D.N.M.)
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19
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Garovic VD, Dechend R, Easterling T, Karumanchi SA, McMurtry Baird S, Magee LA, Rana S, Vermunt JV, August P. Hypertension in Pregnancy: Diagnosis, Blood Pressure Goals, and Pharmacotherapy: A Scientific Statement From the American Heart Association. Hypertension 2022; 79:e21-e41. [PMID: 34905954 PMCID: PMC9031058 DOI: 10.1161/hyp.0000000000000208] [Citation(s) in RCA: 133] [Impact Index Per Article: 66.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Hypertensive disorders of pregnancy (HDP) remain one of the major causes of pregnancy-related maternal and fetal morbidity and mortality worldwide. Affected women are also at increased risk for cardiovascular disease later in life, independently of traditional cardiovascular disease risks. Despite the immediate and long-term cardiovascular disease risks, recommendations for diagnosis and treatment of HDP in the United States have changed little, if at all, over past decades, unlike hypertension guidelines for the general population. The reasons for this approach include the question of benefit from normalization of blood pressure treatment for pregnant women, coupled with theoretical concerns for fetal well-being from a reduction in utero-placental perfusion and in utero exposure to antihypertensive medication. This report is based on a review of current literature and includes normal physiological changes in pregnancy that may affect clinical presentation of HDP; HDP epidemiology and the immediate and long-term sequelae of HDP; the pathophysiology of preeclampsia, an HDP commonly associated with proteinuria and increasingly recognized as a heterogeneous disease with different clinical phenotypes and likely distinct pathological mechanisms; a critical overview of current national and international HDP guidelines; emerging evidence that reducing blood pressure treatment goals in pregnancy may reduce maternal severe hypertension without increasing the risk of pregnancy loss, high-level neonatal care, or overall maternal complications; and the increasingly recognized morbidity associated with postpartum hypertension/preeclampsia. Finally, we discuss the future of research in the field and the pressing need to study socioeconomic and biological factors that may contribute to racial and ethnic maternal health care disparities.
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20
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Pitz Jacobsen D, Fjeldstad HE, Johnsen GM, Fosheim IK, Moe K, Alnæs-Katjavivi P, Dechend R, Sugulle M, Staff AC. Acute Atherosis Lesions at the Fetal-Maternal Border: Current Knowledge and Implications for Maternal Cardiovascular Health. Front Immunol 2021; 12:791606. [PMID: 34970270 PMCID: PMC8712939 DOI: 10.3389/fimmu.2021.791606] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/22/2021] [Indexed: 12/15/2022] Open
Abstract
Decidua basalis, the endometrium of pregnancy, is an important interface between maternal and fetal tissues, made up of both maternal and fetal cells. Acute atherosis is a uteroplacental spiral artery lesion. These patchy arterial wall lesions containing foam cells are predominantly found in the decidua basalis, at the tips of the maternal arteries, where they feed into the placental intervillous space. Acute atherosis is prevalent in preeclampsia and other obstetric syndromes such as fetal growth restriction. Causal factors and effects of acute atherosis remain uncertain. This is in part because decidua basalis is challenging to sample systematically and in large amounts following delivery. We summarize our decidua basalis vacuum suction method, which facilitates tissue-based studies of acute atherosis. We also describe our evidence-based research definition of acute atherosis. Here, we comprehensively review the existing literature on acute atherosis, its underlying mechanisms and possible short- and long-term effects. We propose that multiple pathways leading to decidual vascular inflammation may promote acute atherosis formation, with or without poor spiral artery remodeling and/or preeclampsia. These include maternal alloreactivity, ischemia-reperfusion injury, preexisting systemic inflammation, and microbial infection. The concept of acute atherosis as an inflammatory lesion is not novel. The lesions themselves have an inflammatory phenotype and resemble other arterial lesions of more extensively studied etiology. We discuss findings of concurrently dysregulated proteins involved in immune regulation and cardiovascular function in women with acute atherosis. We also propose a novel hypothesis linking cellular fetal microchimerism, which is prevalent in women with preeclampsia, with acute atherosis in pregnancy and future cardiovascular and neurovascular disease. Finally, women with a history of preeclampsia have an increased risk of premature cardiovascular disease. We review whether presence of acute atherosis may identify women at especially high risk for premature cardiovascular disease.
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Affiliation(s)
| | - Heidi Elisabeth Fjeldstad
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Guro Mørk Johnsen
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Ingrid Knutsdotter Fosheim
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kjartan Moe
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Obstetrics and Gynaecology, Bærum Hospital, Vestre Viken HF, Bærum, Norway
| | | | - Ralf Dechend
- Experimental and Clinical Research Center, A Cooperation of Charité-Universitätsmedizin Berlin and Max-Delbruck Center for Molecular Medicine, Berlin, Germany
- Department of Cardiology and Nephrology, HELIOS-Klinikum, Berlin, Germany
| | - Meryam Sugulle
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne Cathrine Staff
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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21
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Schütte T, Kedziora SM, Haase N, Herse F, Alenina N, Müller DN, Bader M, Schupp M, Dechend R, Golic M, Kräker K. Diabetic pregnancy as a novel risk factor for cardiac dysfunction in the offspring-the heart as a target for fetal programming in rats. Diabetologia 2021; 64:2829-2842. [PMID: 34537857 PMCID: PMC8563640 DOI: 10.1007/s00125-021-05566-5] [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] [Received: 01/15/2021] [Accepted: 05/28/2021] [Indexed: 11/02/2022]
Abstract
AIMS/HYPOTHESIS The impact of diabetic pregnancy has been investigated extensively regarding offspring metabolism; however, little is known about the influence on the heart. We aimed to characterise the effects of a diabetic pregnancy on male adult offspring cardiac health after feeding a high-fat diet in an established transgenic rat model. METHODS We applied our rat model for maternal type 2 diabetes characterised by maternal insulin resistance with hyperglycaemia and hyperinsulinaemia. Diabetes was induced preconceptionally via doxycycline-induced knock down of the insulin receptor in transgenic rats. Male wild-type offspring of diabetic and normoglycaemic pregnancies were raised by foster mothers, followed up into adulthood and subgroups were challenged by a high-fat diet. Cardiac phenotype was assessed by innovative speckle tracking echocardiography, circulating factors, immunohistochemistry and gene expression in the heart. RESULTS When feeding normal chow, we did not observe differences in cardiac function, gene expression and plasma brain natriuretic peptide between adult diabetic or normoglycaemic offspring. Interestingly, when being fed a high-fat diet, adult offspring of diabetic pregnancy demonstrated decreased global longitudinal (-14.82 ± 0.59 vs -16.60 ± 0.48%) and circumferential strain (-23.40 ± 0.57 vs -26.74 ± 0.34%), increased relative wall thickness (0.53 ± 0.06 vs 0.37 ± 0.02), altered cardiac gene expression, enlarged cardiomyocytes (106.60 ± 4.14 vs 87.94 ± 1.67 μm), an accumulation of immune cells in the heart (10.27 ± 0.30 vs 6.48 ± 0.48 per fov) and higher plasma brain natriuretic peptide levels (0.50 ± 0.12 vs 0.12 ± 0.03 ng/ml) compared with normoglycaemic offspring on a high-fat diet. Blood pressure, urinary albumin, blood glucose and body weight were unaltered between groups on a high-fat diet. CONCLUSIONS/INTERPRETATION Diabetic pregnancy in rats induces cardiac dysfunction, left ventricular hypertrophy and altered proinflammatory status in adult offspring only after a high-fat diet. A diabetic pregnancy itself was not sufficient to impair myocardial function and gene expression in male offspring later in life. This suggests that a postnatal high-fat diet is important for the development of cardiac dysfunction in rat offspring after diabetic pregnancy. Our data provide evidence that a diabetic pregnancy is a novel cardiac risk factor that becomes relevant when other challenges, such as a high-fat diet, are present.
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Affiliation(s)
- Till Schütte
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Pharmacology, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Sarah M Kedziora
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Experimental and Clinical Research Center - a joint cooperation between the Max Delbrück Center for Molecular Medicine and the Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nadine Haase
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Experimental and Clinical Research Center - a joint cooperation between the Max Delbrück Center for Molecular Medicine and the Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Florian Herse
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Experimental and Clinical Research Center - a joint cooperation between the Max Delbrück Center for Molecular Medicine and the Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Natalia Alenina
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Dominik N Müller
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Experimental and Clinical Research Center - a joint cooperation between the Max Delbrück Center for Molecular Medicine and the Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Bader
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Institute for Biology, University of Lübeck, Lübeck, Germany
| | - Michael Schupp
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Pharmacology, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ralf Dechend
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Experimental and Clinical Research Center - a joint cooperation between the Max Delbrück Center for Molecular Medicine and the Charité - Universitätsmedizin Berlin, Berlin, Germany
- HELIOS-Klinikum, Department of Cardiology and Nephrology, Berlin, Germany
| | - Michaela Golic
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Experimental and Clinical Research Center - a joint cooperation between the Max Delbrück Center for Molecular Medicine and the Charité - Universitätsmedizin Berlin, Berlin, Germany
- HSD Hochschule Döpfer, University of Applied Sciences, Cologne, Germany
| | - Kristin Kräker
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany.
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.
- Experimental and Clinical Research Center - a joint cooperation between the Max Delbrück Center for Molecular Medicine and the Charité - Universitätsmedizin Berlin, Berlin, Germany.
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22
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Manolis AJ, Boden WE, Collins P, Dechend R, Kallistratos MS, Lopez Sendon J, Poulimenos LE, Ambrosio G, Rosano G. State of the art approach to managing angina and ischemia: tailoring treatment to the evidence. Eur J Intern Med 2021; 92:40-47. [PMID: 34419311 DOI: 10.1016/j.ejim.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/24/2021] [Accepted: 08/07/2021] [Indexed: 10/20/2022]
Abstract
Stable angina represents a chronic and often debilitating condition that affects daily activities and quality of life in patients with chronic coronary syndromes (CCS). Current European Society of Cardiology guidelines recommend a four-step approach for the medical treatment of patients taking into consideration hemodynamic variables (heart rate and blood pressure) and the presence or absence of left ventricular dysfunction. However, CCS patients often have several comorbidities and risk factors. Thus, a tailored approach that takes into consideration patient risk factors and comorbidities may have additional benefits beyond angina relief. This is a state of the art review of stable angina treatment based on the currently available evidence.
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Affiliation(s)
- A J Manolis
- Asklepeion General Hospital, Cardiology Department, Athens, Greece; Metropolitan General Hospital, Cardiology Department, Athens, Greece.
| | - W E Boden
- Department of Medicine, VA Boston Healthcare System, West Roxbury, Massachusetts, USA; Boston University School of Medicine, Boston, Massachusetts, USA
| | - P Collins
- National Heart and Lung Institute, Imperial College London and Royal Brompton Hospital, London, United Kingdom
| | - R Dechend
- Experimental and Clinical Research Center, a joint cooperation between Max-Delbruck Center for Molecular Medicine and Charité - Universitatsmedizin Berlin and HELIOS Clinic Department of Cardiology and Nephrology, Germany
| | - M S Kallistratos
- Asklepeion General Hospital, Cardiology Department, Athens, Greece
| | - J Lopez Sendon
- Servicio de Cardiología, Hospital Universitario La Paz, Instituto de Investigación La Paz (IdiPAZ), Madrid, Spain
| | - L E Poulimenos
- Asklepeion General Hospital, Cardiology Department, Athens, Greece
| | - G Ambrosio
- Division of Cardiology University of Perugia School of Medicine, Italy
| | - G Rosano
- St George's Hospitals NHS Trust University of London - IRCCS San Raffaele Roma, Italy
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23
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Nonn O, Fischer C, Geisberger S, El-Heliebi A, Kroneis T, Forstner D, Desoye G, Staff AC, Sugulle M, Dechend R, Pecks U, Kollmann M, Stern C, Cartwright JE, Whitley GS, Thilaganathan B, Wadsack C, Huppertz B, Herse F, Gauster M. Maternal angiotensin increases placental leptin in early gestation via an alternative RAS-pathway - suggesting a link to pre-eclampsia. Placenta 2021. [DOI: 10.1016/j.placenta.2021.07.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Vogtmann R, Heupel J, Herse F, Matin M, Hagmann H, Kräker K, Bendix I, Dechend R, Winterhager E, Kimmig R, Köninger A, Gellhaus A. Maternal sFLT1 is sufficient to impair spiral arterial remodeling in mice: the link from placental dysfunction to maternal preeclampsia? Placenta 2021. [DOI: 10.1016/j.placenta.2021.07.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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25
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Kraeker K, Napieczynska H, Kedziora S, Haase N, Müller DN, Heuser A, Dechend R. Abstract P233: Microvascular Fingerprint Of Multi-Organ Imaging - New Insights In Preeclampsia Research. Hypertension 2021. [DOI: 10.1161/hyp.78.suppl_1.p233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To establish the first protocol for high-resolution three-dimensional imaging of multiple organs in rodents, we performed microvasculature casting with Microfil silicone rubber substance in non-living rats and combined the method with advanced image analysis protocols after micro-CT scanning. This newly established method allows changes in individual organs to be visualized and examined in extraordinary detail as part of a multi-organ approach. Previously published protocols only address visualization of single organs or are insufficiently resolved with respect to vessel diameter analysis. With optimized staining protocols, samples can additionally be examined for possible structural changes such as inflammatory processes or fibrotic formation. Preeclampsia is a condition during pregnancy that leads to up to a 4-fold increased risk of maternal cardiovascular disease later in life, although symptoms usually resolve after delivery. In former preeclamptic rats, a reduction in microvascular density in the heart and brain with a simultaneous increase in retinal vessels has been described, even weeks after the disappearance of major features such as hypertension and albuminuria. The technique described will enhance studies of the vasculature in many other animal models and provide striking insights into vascular physiology necessary to drive translation.
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Affiliation(s)
- Kristin Kraeker
- Experimental and Clinical Rsch Cntr – a joint cooperation between the Max-Delbrück-Cntr for Molecular Medicine and the Charite – Universitaetsmedizin Berlin, Berlin, Germany
| | | | - Sarah Kedziora
- Experimental and Clinical Rsch Cntr – a joint cooperation between the Max-Delbrück-Cntr for Molecular Medicine and the Charite – Universitaetsmedizin Berlin, Berlin, Germany
| | - Nadine Haase
- Experimental and Clinical Rsch Cntr – a joint cooperation between the Max-Delbrück-Cntr for Molecular Medicine and the Charite – Universitaetsmedizin Berlin, Berlin, Germany
| | - Dominik N. Müller
- Experimental and Clinical Rsch Cntr – a joint cooperation between the Max-Delbrück-Cntr for Molecular Medicine and the Charite – Universitaetsmedizin Berlin, Berlin, Germany
| | - Arnd Heuser
- Max-Delbrück-Cntr for Molecular Medicine, Berlin, Germany
| | - Ralf Dechend
- Experimental and Clinical Rsch Cntr – a joint cooperation between the Max-Delbrück-Cntr for Molecular Medicine and the Charite – Universitaetsmedizin Berlin and Helios Clinic, Berlin, Germany
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26
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Nonn O, Debnath O, Valdes DS, Fischer C, Secener K, Tiesmeyer S, Ishaque N, Sallinger K, El-Heliebi A, Staff A, Mueller DN, Dechend R, Gauster M, Herse F. Abstract 27: Unravelling Cell-specific Interactions At The Preeclamptic Maternal-foetal Interface From Early To Late Pregnancy. Hypertension 2021. [DOI: 10.1161/hyp.78.suppl_1.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Preeclamptic syndrome arrises in the fetal part of the placenta (villi). In this study, we analyse placental development by single nuclei RNA-sequencing in early and term pregnancy and draw conclusions about pathological processes in preeclampsia (PE) that originate early in gestation. We profiled the transcriptome of 101,067 nuclei obtained from a total of 12 pregnancies, spanning early, term and PE doners. Using unsupervised computational approaches, we identified 12 and 16 different cell types and states in decidua and villi, respectively. Our comprehensively identified catalogue of cell types and states aligns well with the previous single cell studies. We identified different subpopulations of syncytiotrophoblast and GATA3+/GREM2+ trophoblast stem cells (TSC) in villi. Through gestation, gene expression in cell populations from the matrisome or vascular environments show dynamic expression reflecting vascular development associated with spiral artery remodelling and concordant decidual stroma reorganisation. Global differential gene expression analysis shows that trophoblast cell types are most dysregulated in PE. Cell-cell communication analysis revealed important dysregulation between villi and decidual cell types. The secretory signalling characteristic of this trophoblastic disease may be used for early biomarker screening. Overall, this study paves the way to a deeper understanding of the early pathophysiology of PE. Figure 1: Villi (v) and decidua (d) cell clusters from early, late control and preeclampsia (PE) villi and decidua visualised as a UMAP. Datasets were integrated separately for each tissue and merged for embedding.
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Affiliation(s)
| | | | - Daniela S Valdes
- Med Univ of Graz, Max-Delbrück-Cntr for Moleculare Medicine, Germany
| | | | - Kerim Secener
- Max-Delbrück-Cntr for Moleculare Medicine, Berlin, Germany
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27
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Kedziora SM, Obermayer B, Sugulle M, Herse F, Kräker K, Haase N, Langmia I, Müller DN, Staff A, Beule D, Dechend R. Abstract P226: Transcriptome Signature Of Placentas From Diabetic Pregnancies Is Confounded By Fetal Sex. Hypertension 2021. [DOI: 10.1161/hyp.78.suppl_1.p226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hypertension-associated obstetric diseases like diabetes mellitus (DM) or preeclampsia occur in 25-35% of pregnancies and are related to placental dysfunction. The placenta has a unique structure and function to guarantee healthy pregnancy, fetal development, and outcome. Thus, the diabetic environment featuring inflammation, metabolic alterations, and hypoxia, is challenging with increased stress for mother and foetus. Delivery-related complications and adverse post-pregnancy outcomes, for example the increased risk for preeclampsia, are related to placental pathology in the different types of DM. Therefore, understanding disturbed placental development during pathologic pregnancy is important. We hypothesize a placental transcriptome signature present in pathologic pregnancy. We aimed to broaden our understanding of placental adaptations to various forms of diabetic pregnancy. Human placenta samples from healthy controls (n = 29), women with gestational DM (GDM, n = 12), DM type 1 (DM1, n = 17), DM type 2 (DM2, n = 3) and GDM, DM1 or DM2 superimposed by preeclampsia (n = 16) were included. We quantified gene expression by Illumina TruSeq stranded total RNA Sequencing and analyzed data by means of principal component analysis (PCA), differential expression and gene set enrichment. The samples were mainly split by fetal sex in the PCA rather than diabetic subgroups. Genes associated with the principal components were primary located on the male sex chromosome (
Xist, Uty, Usp9y, Ddx3y
) and only weakly enriched in functionally relevant gene sets. The fetal sex was identified as single main explanatory variable when the principal components were associated with clinical patient data. Placentas complicated by DM2 identified 93 and 27 significant differential expressed genes (DEG; adj. p-value < 0.05) in comparison to healthy controls and GDM, respectively. Comparison of DM1 to DM2 or GDM showed four and two significant genes. In this cohort possible effects of GDM and preeclampsia were not observed.We conclude that fetal sex is dominating placental gene expression and confounding transcriptome signatures resulting from diabetes, in settings of well controlled diabetic disease.
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Affiliation(s)
| | | | - Meryam Sugulle
- Faculty of Medicine, Div of Obstetrics and Gynaecology, Univ of Oslo, Oslo, Norway
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28
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Vogtmann R, Riedel A, Langer S, Matin M, Herse F, Kräker K, Hagmann H, Dechend R, Kimmig R, Gellhaus A. Placental-specific overexpression of human sFLT1 leads to altered placental morphology and function in transgenic mice. Placenta 2021. [DOI: 10.1016/j.placenta.2021.07.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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29
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Vogtmann R, Heupel J, Herse F, Matin M, Hagmann H, Bendix I, Kräker K, Dechend R, Kimmig R, Gellhaus A. P-042. Circulating sFLT1 is sufficient to impair spiral arterial remodeling in mice: Dissecting the maternal and the placental contribution of preeclampsia. Pregnancy Hypertens 2021. [DOI: 10.1016/j.preghy.2021.07.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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30
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Vogtmann R, Heupel J, Herse F, Matin M, Hagmann H, Bendix I, Kräker K, Dechend R, Winterhager E, Kimmig R, Köninger A, Gellhaus A. Circulating Maternal sFLT1 (Soluble fms-Like Tyrosine Kinase-1) Is Sufficient to Impair Spiral Arterial Remodeling in a Preeclampsia Mouse Model. Hypertension 2021; 78:1067-1079. [PMID: 34397280 PMCID: PMC8415521 DOI: 10.1161/hypertensionaha.121.17567] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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] [Indexed: 12/18/2022]
Abstract
Supplemental Digital Content is available in the text. One driving factor for developing preeclampsia—a pregnancy disorder, often associated with poor spiral artery (SpA)-remodeling and fetal growth restriction—is the anti-angiogenic sFLT1 (soluble fms-like tyrosine kinase-1), which is found to be highly upregulated in preeclampsia patients. The sFLT1-mediated endothelial dysfunction is a common theory for the manifestation of maternal preeclampsia symptoms. However, the influence of sFLT1 on SpA-remodeling and the link between placental and maternal preeclampsia symptoms is less understood. To dissect the hsFLT1 (human sFLT1) effects on maternal and/or fetoplacental physiology in preeclampsia, sFLT1-transgenic mice with systemic hsFLT1 overexpression from midgestation onwards were used. SpA-remodeling was analyzed on histological and molecular level in placental/mesometrial triangle tissues. Maternal kidney and aorta morphology was investigated, combined with blood pressure measurements via telemetry. hsFLT1 overexpression resulted in maternal hypertension, aortic wall thickening, and elastin breakdown. Furthermore, maternal kidneys showed glomerular endotheliosis, podocyte damage, and proteinuria. preeclampsia symptoms were combined with fetal growth restriction already at the end of the second trimester and SpA-remodeling was strongly impaired as shown by persisted vascular smooth muscle cells. This phenotype was associated with shallow trophoblast invasion, delayed presence of uterine natural killer cells, and altered lymphatic angiogenesis. Overall, this study showed that circulating maternal hsFLT1 is sufficient to induce typical maternal preeclampsia-like symptoms in mice and impair the SpA-remodeling independent from the fetoplacental compartment, revealing new insights into the interaction between the placental and maternal contribution of preeclampsia.
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Affiliation(s)
- Rebekka Vogtmann
- Department of Gynecology and Obstetrics, University Hospital Essen, Germany (R.V., J.H., R.K., A.K., A.G.)
| | - Jacqueline Heupel
- Department of Gynecology and Obstetrics, University Hospital Essen, Germany (R.V., J.H., R.K., A.K., A.G.)
| | - Florian Herse
- Experimental and Clinical Research Center (ECRC), a cooperation of Charité - Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine (MDC), Berlin, Germany (F.H., K.K., R.D.).,Max Delbruck Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany (F.H., K.K.)
| | - Mahsa Matin
- Department II of Internal Medicine-Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine-University Hospital Cologne, Cologne, Germany and Cologne Cluster of Excellence on Cellular Stress Responses in Ageing-Associated Diseases, Germany (M.M., H.H.)
| | - Henning Hagmann
- Department II of Internal Medicine-Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine-University Hospital Cologne, Cologne, Germany and Cologne Cluster of Excellence on Cellular Stress Responses in Ageing-Associated Diseases, Germany (M.M., H.H.)
| | - Ivo Bendix
- Department of Pediatrics I, Neonatology & Experimental Perinatal Neurosciences, University Hospital Essen, University of Duisburg-Essen, Germany (I.B.)
| | - Kristin Kräker
- Experimental and Clinical Research Center (ECRC), a cooperation of Charité - Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine (MDC), Berlin, Germany (F.H., K.K., R.D.).,Max Delbruck Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany (F.H., K.K.).,Charité-Universitätsmedizin Berlin and Humboldt-Universität zu Berlin, Berlin, Germany (K.K.)
| | - Ralf Dechend
- Experimental and Clinical Research Center (ECRC), a cooperation of Charité - Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine (MDC), Berlin, Germany (F.H., K.K., R.D.).,HELIOS Klinikum, Berlin, Germany (R.D.)
| | - Elke Winterhager
- Imaging Center Essen, EM Unit, University Hospital Essen, Germany (E.W.)
| | - Rainer Kimmig
- Department of Gynecology and Obstetrics, University Hospital Essen, Germany (R.V., J.H., R.K., A.K., A.G.)
| | - Angela Köninger
- Department of Gynecology and Obstetrics, University Hospital Essen, Germany (R.V., J.H., R.K., A.K., A.G.).,Department of Gynecology and Obstetrics, Clinic of the Order of St. John, St. Hedwigs Clinic, Regensburg, Germany (A.K.)
| | - Alexandra Gellhaus
- Department of Gynecology and Obstetrics, University Hospital Essen, Germany (R.V., J.H., R.K., A.K., A.G.)
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31
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Maifeld A, Wild J, Karlsen TV, Rakova N, Wistorf E, Linz P, Jung R, Birukov A, Gimenez-Rivera VA, Wilck N, Bartolomaeus T, Dechend R, Kleinewietfeld M, Forslund SK, Krause A, Kokolakis G, Philipp S, Clausen BE, Brand A, Waisman A, Kurschus FC, Wegner J, Schultheis M, Luft FC, Boschmann M, Kelm M, Wiig H, Kuehne T, Müller DN, Karbach S, Markó L. Skin Sodium Accumulates in Psoriasis and Reflects Disease Severity. J Invest Dermatol 2021; 142:166-178.e8. [PMID: 34237339 DOI: 10.1016/j.jid.2021.06.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 05/14/2021] [Accepted: 06/03/2021] [Indexed: 12/14/2022]
Abstract
Sodium can accumulate in the skin at concentrations exceeding serum levels. A high sodium environment can lead to pathogenic T helper 17 cell expansion. Psoriasis is a chronic inflammatory skin disease in which IL-17‒producing T helper 17 cells play a crucial role. In an observational study, we measured skin sodium content in patients with psoriasis and in age-matched healthy controls by Sodium-23 magnetic resonance imaging. Patients with PASI > 5 showed significantly higher sodium and water content in the skin but not in other tissues than those with lower PASI or healthy controls. Skin sodium concentrations measured by Sodium-23 spectroscopy or by atomic absorption spectrometry in ashed-skin biopsies verified the findings with Sodium-23 magnetic resonance imaging. In vitro T helper 17 cell differentiation of naive CD4+ cells from patients with psoriasis markedly induced IL-17A expression under increased sodium chloride concentrations. The imiquimod-induced psoriasis mouse model replicated the human findings. Extracellular tracer Chromium-51-EDTA measurements in imiquimod- and sham-treated skin showed similar extracellular volumes, rendering excessive water of intracellular origin. Chronic genetic IL-17A‒driven psoriasis mouse models underlined the role of IL-17A in dermal sodium accumulation and inflammation. Our data describe skin sodium as a pathophysiological feature of psoriasis, which could open new avenues for its treatment.
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Affiliation(s)
- András Maifeld
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany; German Centre for Cardiovascular Research (DZHK), Berlin, Germany; Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Berlin, Germany; Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Johannes Wild
- Center of Cardiology - Cardiology I, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany; Center for Thrombosis and Hemostasis (CTH), University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Tine V Karlsen
- Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Natalia Rakova
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Elisa Wistorf
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Peter Linz
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany; Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Rebecca Jung
- Center for Thrombosis and Hemostasis (CTH), University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany; Institute for Molecular Medicine, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Anna Birukov
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany; German Centre for Cardiovascular Research (DZHK), Berlin, Germany; Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | | | - Nicola Wilck
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany; German Centre for Cardiovascular Research (DZHK), Berlin, Germany; Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Berlin, Germany; Department of Nephrology and Internal Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Theda Bartolomaeus
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany; German Centre for Cardiovascular Research (DZHK), Berlin, Germany; Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ralf Dechend
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany; German Centre for Cardiovascular Research (DZHK), Berlin, Germany; Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Berlin, Germany; Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Helios Clinic Berlin-Buch, Berlin, Germany
| | - Markus Kleinewietfeld
- VIB Laboratory of Translational Immunomodulation, VIB Center for Inflammation Research (IRC), Hasselt University Campus Diepenbeek, Hasselt, Belgium
| | - Sofia K Forslund
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany; German Centre for Cardiovascular Research (DZHK), Berlin, Germany; Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Berlin, Germany; Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andreas Krause
- Medical Centre for Rheumatology and Clinical Immunology, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Georgios Kokolakis
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sandra Philipp
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Björn E Clausen
- Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Anna Brand
- Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Ari Waisman
- Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Florian C Kurschus
- Department of Dermatology, Heidelberg University Hospital, Heidelberg, Germany
| | - Joanna Wegner
- Department of Dermatology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Michael Schultheis
- Department of Dermatology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Friedrich C Luft
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Michael Boschmann
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany; Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Berlin, Germany; Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Marcus Kelm
- Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Berlin, Germany; Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Congenital Heart Disease, German Heart Center Berlin (DHZB), Berlin, Germany
| | - Helge Wiig
- Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Titus Kuehne
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Congenital Heart Disease, German Heart Center Berlin (DHZB), Berlin, Germany
| | - Dominik N Müller
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany; German Centre for Cardiovascular Research (DZHK), Berlin, Germany; Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Berlin, Germany; Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Max Delbrück Center for Molecular Medicine in the Helmholtz Association Berlin, Berlin, Germany
| | - Susanne Karbach
- Center of Cardiology - Cardiology I, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany; Center for Thrombosis and Hemostasis (CTH), University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Lajos Markó
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany; German Centre for Cardiovascular Research (DZHK), Berlin, Germany; Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Berlin, Germany; Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
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32
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Mary S, Small H, Herse F, Carrick E, Flynn A, Mullen W, Dechend R, Delles C. Preexisting hypertension and pregnancy-induced hypertension reveal molecular differences in placental proteome in rodents. Physiol Genomics 2021; 53:259-268. [PMID: 33969702 PMCID: PMC8616587 DOI: 10.1152/physiolgenomics.00160.2020] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/28/2021] [Accepted: 05/05/2021] [Indexed: 01/20/2023] Open
Abstract
Preexisting or new onset of hypertension affects pregnancy and is one of the leading causes of maternal and fetal morbidity and mortality. In certain cases, it also leads to long-term maternal cardiovascular complications. The placenta is a key player in the pathogenesis of complicated hypertensive pregnancies, however the pathomechanisms leading to an abnormal placenta are poorly understood. In this study, we compared the placental proteome of two pregnant hypertensive models with their corresponding normotensive controls: a preexisting hypertension pregnancy model (stroke-prone spontaneously hypertensive rats; SHRSP) versus Wistar-Kyoto and the transgenic RAS activated gestational hypertension model (transgenic for human angiotensinogen Sprague-Dawley rats; SD-PE) versus Sprague-Dawley rats, respectively. Label-free proteomics using nano LC-MS/MS was performed for identification and quantification of proteins. Between the two models, we found widespread differences in the expression of placental proteins including those related to hypertension, inflammation, and trophoblast invasion, whereas pathways such as regulation of serine endopeptidase activity, tissue injury response, coagulation, and complement activation were enriched in both models. We present for the first time the placental proteome of SHRSP and SD-PE and provide insight into the molecular make-up of models of hypertensive pregnancy. Our study informs future research into specific preeclampsia and chronic hypertension pregnancy mechanisms and translation of rodent data to the clinic.
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Affiliation(s)
- Sheon Mary
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, United Kingdom
| | - Heather Small
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, United Kingdom
| | - Florian Herse
- Experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Emma Carrick
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, United Kingdom
| | - Arun Flynn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, United Kingdom
| | - William Mullen
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, United Kingdom
| | - Ralf Dechend
- Experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Cardiology and Nephrology, HELIOS Clinic, Berlin, Germany
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, United Kingdom
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33
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Birukov A, Andersen LB, Andersen MS, Nielsen JH, Nielsen F, Kyhl HB, Jørgensen JS, Grandjean P, Dechend R, Jensen TK. Exposure to perfluoroalkyl substances and blood pressure in pregnancy among 1436 women from the Odense Child Cohort. Environ Int 2021; 151:106442. [PMID: 33610053 DOI: 10.1016/j.envint.2021.106442] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/08/2021] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Previous studies of association between exposure to poly- and perfluoroalkyl substances (PFAS) and gestational hypertension (GH) and preeclampsia (PE) have shown conflicting results, but most dichotomized outcome and did not study continuous blood pressure (BP) changes. OBJECTIVES To study the association between PFAS exposure in early pregnancy and maternal BP trajectories in pregnancy, gestational hypertension and preeclampsia. METHODS 1436 women were enrolled in the Odense Child Cohort in early pregnancy and had a serum sample drawn, from which perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDA) were measured using LC-MS/MS. Repeated BP measurements through pregnancy and information on PE were obtained from hospital files. Adjusted linear mixed models were used to investigate association between PFAS exposure and BP trajectory. Associations between PFAS and PE and GH were assessed by Cox proportional hazards model. RESULTS All women had measurable concentrations of PFAS. In all of many comparisons higher PFAS exposure (apart from PFHxS) was associated with higher systolic (SBP) and diastolic (DBP) blood pressures, although not all were significant, which is unlikely to be due to chance. After adjustment, each doubling in PFOS or PFOA exposure was associated with 0.47 mmHg (95% CI: -0.13; 1.08) and 0.36 mmHg (-0.19; 0.92) higher SBP; and 0.58 mmHg (0.13; 1.04) and 0.37 mmHg (-0.05; 0.79) higher DBP. No clear associations between PFAS exposure and PE or GH were found. DISCUSSION The magnitude of the association between PFAS exposure and BP might appear small, statistically non-significant and the possible clinical importance low. However, at a population level this may slightly shift the distribution of BP towards an increased incidence of GH. If BP increases in pregnancy, it may have long-term impact on health not only of the pregnant woman but also of her offspring.
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Affiliation(s)
- Anna Birukov
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany; German Center for Diabetes Research München-Neuherberg, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Louise Bjørkholt Andersen
- Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Marianne Skovsager Andersen
- Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
| | - Julie H Nielsen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark; Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
| | - Flemming Nielsen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Henriette Boye Kyhl
- Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; OPEN Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Jan Stener Jørgensen
- Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Philippe Grandjean
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark; Harvard T.H.Chan School of Public Health, Boston, USA
| | - Ralf Dechend
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany; Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark; HELIOS-Klinikum, Berlin, Department of Cardiology and Nephrology, Germany; Experimental and Clinical Research Center, Joint Cooperation Between Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany
| | - Tina Kold Jensen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark; Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; OPEN Patient Data Explorative Network, Odense University Hospital, Odense, Denmark.
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Lekva T, Jacobsen DP, Sugulle M, Moe K, Fjeldstad HES, Dechend R, Staff AC. Circulating HLA-G and its association with cardiovascular markers in pregnancy. J Reprod Immunol 2021; 146:103331. [PMID: 34030048 DOI: 10.1016/j.jri.2021.103331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/06/2021] [Accepted: 05/16/2021] [Indexed: 11/29/2022]
Abstract
Human Leukocyte Antigen-G (HLA-G) prevents the activity of immune cells and is decreased in women with preeclampsia. We aimed to investigate the associations between circulating soluble HLA-G (sHLA-G) and 92 cardiovascular disease-related biomarkers from a previously published multiplex study in women with preeclampsia and controls. We found 15 markers significantly associated with circulating sHLA-G in univariate analyses. After multivariable adjusted regression, only proto-oncogene tyrosine-protein kinase Src (SRC) and vascular endothelial growth factor D were significantly associated with sHLA-G. Low SRC, previously observed in the circulation of preeclamptic women, may be regulated by low sHLA-G, and reflect decreased trophoblast differentiation and syncytical formation.
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Affiliation(s)
- Tove Lekva
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway; Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Norway.
| | - Daniel P Jacobsen
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway
| | - Meryam Sugulle
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway
| | - Kjartan Moe
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway; Department of Obstetrics and Gynaecology, Bærum Hospital, Vestre Viken Hospital Trust, Norway
| | - Heidi E S Fjeldstad
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway; Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
| | - Ralf Dechend
- Experimental and Clinical Research Center, A Cooperation of Charité-Universitätsmedizin Berlin and Max-Delbruck Center for Molecular Medicine, Germany; Department of Cardiology and Nephrology, HELIOS-Klinikum, Berlin, Germany
| | - Anne Cathrine Staff
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway; Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
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Geisberger S, Bartolomaeus H, Neubert P, Willebrand R, Zasada C, Bartolomaeus T, McParland V, Swinnen D, Geuzens A, Maifeld A, Krampert L, Vogl M, Mähler A, Wilck N, Markó L, Tilic E, Forslund SK, Binger KJ, Stegbauer J, Dechend R, Kleinewietfeld M, Jantsch J, Kempa S, Müller DN. Salt Transiently Inhibits Mitochondrial Energetics in Mononuclear Phagocytes. Circulation 2021; 144:144-158. [PMID: 33906377 PMCID: PMC8270232 DOI: 10.1161/circulationaha.120.052788] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Supplemental Digital Content is available in the text. Background: Dietary high salt (HS) is a leading risk factor for mortality and morbidity. Serum sodium transiently increases postprandially but can also accumulate at sites of inflammation affecting differentiation and function of innate and adaptive immune cells. Here, we focus on how changes in extracellular sodium, mimicking alterations in the circulation and tissues, affect the early metabolic, transcriptional, and functional adaption of human and murine mononuclear phagocytes. Methods: Using Seahorse technology, pulsed stable isotope-resolved metabolomics, and enzyme activity assays, we characterize the central carbon metabolism and mitochondrial function of human and murine mononuclear phagocytes under HS in vitro. HS as well as pharmacological uncoupling of the electron transport chain under normal salt is used to analyze mitochondrial function on immune cell activation and function (as determined by Escherichiacoli killing and CD4+ T cell migration capacity). In 2 independent clinical studies, we analyze the effect of a HS diet during 2 weeks (URL: http://www.clinicaltrials.gov. Unique identifier: NCT02509962) and short-term salt challenge by a single meal (URL: http://www.clinicaltrials.gov. Unique identifier: NCT04175249) on mitochondrial function of human monocytes in vivo. Results: Extracellular sodium was taken up into the intracellular compartment, followed by the inhibition of mitochondrial respiration in murine and human macrophages. Mechanistically, HS reduces mitochondrial membrane potential, electron transport chain complex II activity, oxygen consumption, and ATP production independently of the polarization status of macrophages. Subsequently, cell activation is altered with improved bactericidal function in HS-treated M1-like macrophages and diminished CD4+ T cell migration in HS-treated M2-like macrophages. Pharmacological uncoupling of the electron transport chain under normal salt phenocopies HS-induced transcriptional changes and bactericidal function of human and murine mononuclear phagocytes. Clinically, also in vivo, rise in plasma sodium concentration within the physiological range reversibly reduces mitochondrial function in human monocytes. In both a 14-day and single meal HS challenge, healthy volunteers displayed a plasma sodium increase of and respectively, that correlated with decreased monocytic mitochondrial oxygen consumption. Conclusions: Our data identify the disturbance of mitochondrial respiration as the initial step by which HS mechanistically influences immune cell function. Although these functional changes might help to resolve bacterial infections, a shift toward proinflammation could accelerate inflammatory cardiovascular disease.
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Affiliation(s)
- Sabrina Geisberger
- Experimental and Clinical Research Center, a joint cooperation of Max-Delbrück-Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,Integrative Proteomics and Metabolomics, Berlin Institute for Medical Systems Biology, Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Germany (S.G., C.Z., S.K.).,German Center for Cardiovascular Research, partner site Berlin (S.G., H.B., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.)
| | - Hendrik Bartolomaeus
- Experimental and Clinical Research Center, a joint cooperation of Max-Delbrück-Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,German Center for Cardiovascular Research, partner site Berlin (S.G., H.B., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany (H.B., V.M., A. Maifeld, A. Mähler, L.M., S.K.F., R.D., D.N.M.).,Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.)
| | - Patrick Neubert
- Institute of Clinical Microbiology and Hygiene, University Hospital of Regensburg, University of Regensburg, Germany (P.N., L.K., M.V., J.J.)
| | - Ralf Willebrand
- VIB Laboratory of Translational Immunomodulation, VIB Center for Inflammation Research, UHasselt, Campus Diepenbeek, Belgium (R.W., D.S., A.G., M.K.)
| | - Christin Zasada
- Integrative Proteomics and Metabolomics, Berlin Institute for Medical Systems Biology, Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Germany (S.G., C.Z., S.K.)
| | | | - Victoria McParland
- Experimental and Clinical Research Center, a joint cooperation of Max-Delbrück-Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany (H.B., V.M., A. Maifeld, A. Mähler, L.M., S.K.F., R.D., D.N.M.).,Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.)
| | - Dries Swinnen
- VIB Laboratory of Translational Immunomodulation, VIB Center for Inflammation Research, UHasselt, Campus Diepenbeek, Belgium (R.W., D.S., A.G., M.K.)
| | - Anneleen Geuzens
- VIB Laboratory of Translational Immunomodulation, VIB Center for Inflammation Research, UHasselt, Campus Diepenbeek, Belgium (R.W., D.S., A.G., M.K.)
| | - András Maifeld
- Experimental and Clinical Research Center, a joint cooperation of Max-Delbrück-Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany (H.B., V.M., A. Maifeld, A. Mähler, L.M., S.K.F., R.D., D.N.M.).,Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.)
| | - Luka Krampert
- Institute of Clinical Microbiology and Hygiene, University Hospital of Regensburg, University of Regensburg, Germany (P.N., L.K., M.V., J.J.)
| | - Marion Vogl
- Institute of Clinical Microbiology and Hygiene, University Hospital of Regensburg, University of Regensburg, Germany (P.N., L.K., M.V., J.J.)
| | - Anja Mähler
- Experimental and Clinical Research Center, a joint cooperation of Max-Delbrück-Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,German Center for Cardiovascular Research, partner site Berlin (S.G., H.B., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany (H.B., V.M., A. Maifeld, A. Mähler, L.M., S.K.F., R.D., D.N.M.).,Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.)
| | - Nicola Wilck
- Experimental and Clinical Research Center, a joint cooperation of Max-Delbrück-Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,German Center for Cardiovascular Research, partner site Berlin (S.G., H.B., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Germany (N.W.).,Department of Nephrology and Internal Intensive Care Medicine (N.W.).,Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.)
| | - Lajos Markó
- Experimental and Clinical Research Center, a joint cooperation of Max-Delbrück-Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,German Center for Cardiovascular Research, partner site Berlin (S.G., H.B., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany (H.B., V.M., A. Maifeld, A. Mähler, L.M., S.K.F., R.D., D.N.M.).,Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.)
| | - Ekin Tilic
- Institute of Evolutionary Biology, University of Bonn, Germany (T.B., E.T.)
| | - Sofia K Forslund
- Experimental and Clinical Research Center, a joint cooperation of Max-Delbrück-Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,German Center for Cardiovascular Research, partner site Berlin (S.G., H.B., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany (H.B., V.M., A. Maifeld, A. Mähler, L.M., S.K.F., R.D., D.N.M.).,Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.)
| | - Katrina J Binger
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Australia (K.J.B.)
| | - Johannes Stegbauer
- Department of Nephrology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany (J.S.)
| | - Ralf Dechend
- Experimental and Clinical Research Center, a joint cooperation of Max-Delbrück-Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,German Center for Cardiovascular Research, partner site Berlin (S.G., H.B., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany (H.B., V.M., A. Maifeld, A. Mähler, L.M., S.K.F., R.D., D.N.M.).,Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,Department of Cardiology and Nephrology, HELIOS-Klinikum, Berlin, Germany (R.D.)
| | - Markus Kleinewietfeld
- VIB Laboratory of Translational Immunomodulation, VIB Center for Inflammation Research, UHasselt, Campus Diepenbeek, Belgium (R.W., D.S., A.G., M.K.)
| | - Jonathan Jantsch
- Institute of Clinical Microbiology and Hygiene, University Hospital of Regensburg, University of Regensburg, Germany (P.N., L.K., M.V., J.J.)
| | - Stefan Kempa
- Integrative Proteomics and Metabolomics, Berlin Institute for Medical Systems Biology, Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Germany (S.G., C.Z., S.K.)
| | - Dominik N Müller
- Experimental and Clinical Research Center, a joint cooperation of Max-Delbrück-Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,German Center for Cardiovascular Research, partner site Berlin (S.G., H.B., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.).,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany (H.B., V.M., A. Maifeld, A. Mähler, L.M., S.K.F., R.D., D.N.M.).,Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.G., H.B., V.M., A. Maifeld, A. Mähler, N.W., L.M., S.K.F., R.D., D.N.M.)
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Kedziora SM, Kräker K, Markó L, Binder J, Sugulle M, Gauster M, Müller DN, Dechend R, Haase N, Herse F. Kidney Injury Caused by Preeclamptic Pregnancy Recovers Postpartum in a Transgenic Rat Model. Int J Mol Sci 2021; 22:ijms22073762. [PMID: 33916404 PMCID: PMC8038582 DOI: 10.3390/ijms22073762] [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] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/26/2021] [Accepted: 03/31/2021] [Indexed: 11/21/2022] Open
Abstract
Preeclampsia (PE) is characterized by the onset of hypertension (≥140/90 mmHg) and presence of proteinuria (>300 mg/L/24 h urine) or other maternal organ dysfunctions. During human PE, renal injuries have been observed. Some studies suggest that women with PE diagnosis have an increased risk to develop renal diseases later in life. However, in human studies PE as a single cause of this development cannot be investigated. Here, we aimed to investigate the effect of PE on postpartum renal damage in an established transgenic PE rat model. Female rats harboring the human-angiotensinogen gene develop a preeclamptic phenotype after mating with male rats harboring the human-renin gene, but are normotensive before and after pregnancy. During pregnancy PE rats developed mild tubular and glomerular changes assessed by histologic analysis, increased gene expression of renal damage markers such as kidney injury marker 1 and connective-tissue growth factor, and albuminuria compared to female wild-type rats (WT). However, four weeks postpartum, most PE-related renal pathologies were absent, including albuminuria and elevated biomarker expression. Only mild enlargement of the glomerular tuft could be detected. Overall, the glomerular and tubular function were affected during pregnancy in the transgenic PE rat. However, almost all these pathologies observed during PE recovered postpartum.
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Affiliation(s)
- Sarah M. Kedziora
- Experimental and Clinical Research Center (ECRC), A Joint Cooperation of Charité—Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine, 13125 Berlin, Germany; (S.M.K.); (K.K.); (L.M.); (D.N.M.); (R.D.); (N.H.)
- Max Delbruck Center for Molecular Medicine (MDC) in the Helmholtz Association, 13125 Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, 10117 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 13353 Berlin, Germany
| | - Kristin Kräker
- Experimental and Clinical Research Center (ECRC), A Joint Cooperation of Charité—Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine, 13125 Berlin, Germany; (S.M.K.); (K.K.); (L.M.); (D.N.M.); (R.D.); (N.H.)
- Max Delbruck Center for Molecular Medicine (MDC) in the Helmholtz Association, 13125 Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, 10117 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 13353 Berlin, Germany
| | - Lajos Markó
- Experimental and Clinical Research Center (ECRC), A Joint Cooperation of Charité—Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine, 13125 Berlin, Germany; (S.M.K.); (K.K.); (L.M.); (D.N.M.); (R.D.); (N.H.)
- Max Delbruck Center for Molecular Medicine (MDC) in the Helmholtz Association, 13125 Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, 10117 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 13353 Berlin, Germany
| | - Julia Binder
- Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria;
| | - Meryam Sugulle
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway;
- Division of Obstetrics and Gynaecology, Oslo University Hospital, 0450 Oslo, Norway
| | - Martin Gauster
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Centre, Medical University of Graz, 8036 Graz, Austria;
| | - Dominik N. Müller
- Experimental and Clinical Research Center (ECRC), A Joint Cooperation of Charité—Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine, 13125 Berlin, Germany; (S.M.K.); (K.K.); (L.M.); (D.N.M.); (R.D.); (N.H.)
- Max Delbruck Center for Molecular Medicine (MDC) in the Helmholtz Association, 13125 Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, 10117 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 13353 Berlin, Germany
| | - Ralf Dechend
- Experimental and Clinical Research Center (ECRC), A Joint Cooperation of Charité—Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine, 13125 Berlin, Germany; (S.M.K.); (K.K.); (L.M.); (D.N.M.); (R.D.); (N.H.)
- Max Delbruck Center for Molecular Medicine (MDC) in the Helmholtz Association, 13125 Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, 10117 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 13353 Berlin, Germany
- Helios Klinikum, 13125 Berlin, Germany
| | - Nadine Haase
- Experimental and Clinical Research Center (ECRC), A Joint Cooperation of Charité—Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine, 13125 Berlin, Germany; (S.M.K.); (K.K.); (L.M.); (D.N.M.); (R.D.); (N.H.)
- Max Delbruck Center for Molecular Medicine (MDC) in the Helmholtz Association, 13125 Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, 10117 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 13353 Berlin, Germany
| | - Florian Herse
- Experimental and Clinical Research Center (ECRC), A Joint Cooperation of Charité—Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine, 13125 Berlin, Germany; (S.M.K.); (K.K.); (L.M.); (D.N.M.); (R.D.); (N.H.)
- Max Delbruck Center for Molecular Medicine (MDC) in the Helmholtz Association, 13125 Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, 10117 Berlin, Germany
- Correspondence:
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Nonn O, Fischer C, Geisberger S, El-Heliebi A, Kroneis T, Forstner D, Desoye G, Staff AC, Sugulle M, Dechend R, Pecks U, Kollmann M, Stern C, Cartwright JE, Whitley GS, Thilaganathan B, Wadsack C, Huppertz B, Herse F, Gauster M. Maternal Angiotensin Increases Placental Leptin in Early Gestation via an Alternative Renin-Angiotensin System Pathway: Suggesting a Link to Preeclampsia. Hypertension 2021; 77:1723-1736. [PMID: 33775117 DOI: 10.1161/hypertensionaha.120.16425] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Olivia Nonn
- From the Division of Cell Biology, Histology and Embryology (O.N., A.E.-H., T.K., D.F., B.H., M.G.), Medical University of Graz, Austria
| | - Cornelius Fischer
- Berlin Institute of Systems Biology, Max Delbrueck Centre for Molecular Medicine in the Helmholtz Association, Germany (C.F., S.G.)
| | - Sabrina Geisberger
- Berlin Institute of Systems Biology, Max Delbrueck Centre for Molecular Medicine in the Helmholtz Association, Germany (C.F., S.G.).,Experimental Clinical Research Centre, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association and Charité Berlin, Germany (S.G., R.D., F.H.).,DZHK (German Center for Cardiovascular Research), partner site Berlin, Germany (S.G.).,Berlin Institute of Health (BIH), Berlin, Germany (S.G.)
| | - Amin El-Heliebi
- From the Division of Cell Biology, Histology and Embryology (O.N., A.E.-H., T.K., D.F., B.H., M.G.), Medical University of Graz, Austria
| | - Thomas Kroneis
- From the Division of Cell Biology, Histology and Embryology (O.N., A.E.-H., T.K., D.F., B.H., M.G.), Medical University of Graz, Austria
| | - Désirée Forstner
- From the Division of Cell Biology, Histology and Embryology (O.N., A.E.-H., T.K., D.F., B.H., M.G.), Medical University of Graz, Austria
| | - Gernot Desoye
- Gottfried Schatz Research Centre and Department of Obstetrics and Gynecology (G.D., M.K., C.S., C.W.), Medical University of Graz, Austria
| | - Anne Cathrine Staff
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Norway (A.C.S., M.S.).,Division of Obstetrics and Gynecology, Oslo University Hospital, Norway (A.C.S., M.S.)
| | - Meryam Sugulle
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Norway (A.C.S., M.S.).,Division of Obstetrics and Gynecology, Oslo University Hospital, Norway (A.C.S., M.S.)
| | - Ralf Dechend
- Experimental Clinical Research Centre, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association and Charité Berlin, Germany (S.G., R.D., F.H.)
| | - Ulrich Pecks
- Division of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Kiel, Germany (U.P.)
| | - Martina Kollmann
- Gottfried Schatz Research Centre and Department of Obstetrics and Gynecology (G.D., M.K., C.S., C.W.), Medical University of Graz, Austria
| | - Christina Stern
- Gottfried Schatz Research Centre and Department of Obstetrics and Gynecology (G.D., M.K., C.S., C.W.), Medical University of Graz, Austria
| | - Judith E Cartwright
- Molecular and Clinical Sciences Research Institute, St George's, University of London, United Kingdom (J.E.C., G.S.W.)
| | - Guy S Whitley
- Molecular and Clinical Sciences Research Institute, St George's, University of London, United Kingdom (J.E.C., G.S.W.)
| | - Basky Thilaganathan
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, United Kingdom (B.T.)
| | - Christian Wadsack
- Gottfried Schatz Research Centre and Department of Obstetrics and Gynecology (G.D., M.K., C.S., C.W.), Medical University of Graz, Austria
| | - Berthold Huppertz
- From the Division of Cell Biology, Histology and Embryology (O.N., A.E.-H., T.K., D.F., B.H., M.G.), Medical University of Graz, Austria
| | - Florian Herse
- Experimental Clinical Research Centre, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association and Charité Berlin, Germany (S.G., R.D., F.H.)
| | - Martin Gauster
- From the Division of Cell Biology, Histology and Embryology (O.N., A.E.-H., T.K., D.F., B.H., M.G.), Medical University of Graz, Austria
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Haase N, Foster DJ, Cunningham MW, Bercher J, Nguyen T, Shulga-Morskaya S, Milstein S, Shaikh S, Rollins J, Golic M, Herse F, Kräker K, Bendix I, Serdar M, Napieczynska H, Heuser A, Gellhaus A, Thiele K, Wallukat G, Müller DN, LaMarca B, Dechend R. RNA interference therapeutics targeting angiotensinogen ameliorate preeclamptic phenotype in rodent models. J Clin Invest 2021; 130:2928-2942. [PMID: 32338644 DOI: 10.1172/jci99417] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 02/13/2020] [Indexed: 01/03/2023] Open
Affiliation(s)
- Nadine Haase
- Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Berlin Germany.,Experimental and Clinical Research Center, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | | | - Mark W Cunningham
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Julia Bercher
- Experimental and Clinical Research Center, Berlin, Germany
| | - Tuyen Nguyen
- Alnylam Pharmaceuticals, Cambridge, Massachusetts, USA
| | | | | | | | - Jeff Rollins
- Alnylam Pharmaceuticals, Cambridge, Massachusetts, USA
| | - Michaela Golic
- Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Berlin Germany.,Experimental and Clinical Research Center, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Florian Herse
- Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Berlin Germany.,Experimental and Clinical Research Center, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Kristin Kräker
- Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Berlin Germany.,Experimental and Clinical Research Center, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Ivo Bendix
- Department of Pediatrics I Neonatology and Experimental Perinatal Neurosciences and
| | - Meray Serdar
- Department of Pediatrics I Neonatology and Experimental Perinatal Neurosciences and
| | - Hanna Napieczynska
- Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Arnd Heuser
- Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Alexandra Gellhaus
- Department of Gynecology and Obstetrics, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Kristin Thiele
- Department of Experimental Feto-Maternal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gerd Wallukat
- Experimental and Clinical Research Center, Berlin, Germany
| | - Dominik N Müller
- Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Berlin Germany.,Experimental and Clinical Research Center, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Babbette LaMarca
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, USA.,Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Ralf Dechend
- Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Berlin Germany.,Experimental and Clinical Research Center, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,HELIOS-Klinikum, Berlin, Germany.Preeclampsia, with the hallmark features of new-onset hypertension and proteinuria after 20 weeks of gestation, is a major cause of fetal and maternal morbidity and mortality. Studies have demonstrated a role for the renin-angiotensin system (RAS) in its pathogenesis; however, small-molecule RAS blockers are contraindicated because of fetal toxicity. We evaluated whether siRNA targeting maternal hepatic angiotensinogen (Agt, ) could ameliorate symptoms of preeclampsia without adverse placental or fetal effects in 2 rodent models. The first model used a cross of females expressing human Agt, with males expressing human renin, resulting in upregulation of the circulating and uteroplacental RAS. The second model induced ischemia/reperfusion injury and subsequent local and systemic inflammation by surgically reducing placental blood flow mid-gestation (reduced uterine perfusion pressure [RUPP]). These models featured hypertension, proteinuria, and fetal growth restriction, with altered biomarkers. siRNA treatment ameliorated the preeclamptic phenotype in both models, reduced blood pressure, and improved intrauterine growth restriction, with no observed deleterious effects on the fetus. Treatment also improved the angiogenic balance and proteinuria in the transgenic model, and it reduced angiotensin receptor activating antibodies in both. Thus, an RNAi therapeutic targeting Agt, ameliorated the clinical sequelae and improved fetal outcomes in 2 rodent models of preeclampsia
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Reeve KE, Amaral LM, Fitzgerald S, Ibrahim T, Deer E, Herrock O, Harmon A, Wallukat G, Dechend R, LaMarca B. 508 Preeclamptic placental CD4+T cells cause hypertension, AT1-AA stimulation and cNK cells in pregnant nude-athymic rats. Am J Obstet Gynecol 2021. [DOI: 10.1016/j.ajog.2020.12.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Mähler A, Wilck N, Rauch G, Dechend R, Müller DN. Effect of a probiotic on blood pressure in grade 1 hypertension (HYPRO): protocol of a randomized controlled study. Trials 2020; 21:1032. [PMID: 33375942 PMCID: PMC7771080 DOI: 10.1186/s13063-020-04973-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 12/14/2020] [Indexed: 01/19/2023] Open
Abstract
Background Arterial hypertension is a major risk factor for cardiovascular disease and leads to target organ damage including stroke, heart failure, and kidney disease. About 1.5 billion people worldwide have hypertension, and it is estimated that it causes about 8 million deaths each year. Although there are several drugs available to lower blood pressure (BP), a great proportion of treated patients does not reach recommended treatment targets. Typical antihypertensive drugs target the vessels, the kidneys, and the heart. However, our gut microbiota also influences cardiovascular health, and gut dysbiosis is associated with hypertension. In this study protocol, we investigate the potential BP-lowering effect of a probiotic in patients with grade 1 hypertension. Methods This study is an exploratory, randomized, double-blind, placebo-controlled, parallel-group study. One hundred ten patients with grade 1 hypertension (treated or untreated) will be randomized to either the probiotic Vivomixx® or placebo. The primary endpoint is the nocturnal systolic BP measured by ambulatory blood pressure monitoring after 8 weeks adjusted for the baseline value. The secondary endpoints are changes from baseline in nocturnal diastolic BP, antihypertensive medication, fecal microbiome composition, fecal and serum metabolome, immune cell phenotypes, glucose variability after three standardized breakfasts, and health-related quality of life (PROMIS-29). We also assess the safety profile of the intervention. Discussion We postulate that various administrated bacteria (Lactobacilli, Bifidobacteria, and Streptococcus thermophilus) convert dietary components into active metabolites that positively affect immune cell function. A reduction of pro-inflammatory immune cell function could promote a BP-lowering effect. Trial registration ClinicalTrials.gov NCT03906578. Registered on 08 April 2019 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-020-04973-0.
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Affiliation(s)
- Anja Mähler
- Experimental and Clinical Research Center, a cooperation between Charité - Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine, Berlin, Germany. .,Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. .,Berlin Institute of Health, Berlin, Germany. .,DZHK (German Centre for Cardiovascular Research) partner site Berlin, Berlin, Germany.
| | - Nicola Wilck
- Experimental and Clinical Research Center, a cooperation between Charité - Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research) partner site Berlin, Berlin, Germany.,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Medizinische Klinik mit Schwerpunkt Nephrologie und Internistische Intensivmedizin Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Geraldine Rauch
- Berlin Institute of Health, Berlin, Germany.,Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ralf Dechend
- Experimental and Clinical Research Center, a cooperation between Charité - Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research) partner site Berlin, Berlin, Germany.,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Department of Cardiology and Nephrology, HELIOS-Klinikum, Berlin, Germany
| | - Dominik N Müller
- Experimental and Clinical Research Center, a cooperation between Charité - Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research) partner site Berlin, Berlin, Germany.,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
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41
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Schütte T, Kedziora SM, Haase N, Herse F, Busjahn A, Birukov A, Alenina N, Müller DN, Bader M, Schupp M, Dechend R, Kräker K, Golic M. Intrauterine Exposure to Diabetic Milieu Does Not Induce Diabetes and Obesity in Male Adulthood in a Novel Rat Model. Hypertension 2020; 77:202-215. [PMID: 33249866 DOI: 10.1161/hypertensionaha.120.16360] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Several studies show an association of maternal diabetes during pregnancy with adverse offspring metabolic health. Other studies, however, suggest that this effect might be biased by obesity, which is independently associated with offspring metabolic disease and often coexistent to maternal diabetes. We performed a prospective study in a rat model to test the hypothesis that the burden of a diabetic pregnancy without obesity deteriorates metabolic health in male offspring. We generated maternal type 2 diabetes before conception that persisted during pregnancy by knockdown of the insulin receptor in small hairpin RNA-expressing transgenic rats. Male WT (wild type) offspring were followed up until adulthood and metabolically challenged by high-fat diet. Blood glucose was measured continuously via a telemetry device. Glucose and insulin tolerance tests were performed, and body composition was analyzed. Weight gain and glucose levels during adolescence and adulthood were similar in male offspring of diabetic and control pregnancies. Body weight and fat mass after high-fat diet, as well as glucose and insulin tolerance tests, were unaltered between male adult offspring of both groups. Glycemic control consisting of up to 49 000 individual glucose measures was comparable between both groups. Intrauterine exposure to maternal hyperglycemia and hyperinsulinemia without obesity had no impact on male offspring metabolic health in our model. We conclude that the intrauterine exposure itself does not represent a mechanism for fetal programming of diabetes and obesity in our model. Other maternal metabolic parameters during pregnancy, such as obesity, might impact long-term offspring metabolic health.
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Affiliation(s)
- Till Schütte
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Institute of Pharmacology, Berlin, Germany (T.S., M.S.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.)
| | - Sarah M Kedziora
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
| | - Nadine Haase
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
| | - Florian Herse
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
| | | | - Anna Birukov
- German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.).,Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany (A. Birukov).,German Center for Diabetes Research, München-Neuherberg, Germany (A. Birukov)
| | - Natalia Alenina
- Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.)
| | - Dominik N Müller
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
| | - Michael Bader
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Institute for Biology, University of Lübeck, Germany (M.B.)
| | - Michael Schupp
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Institute of Pharmacology, Berlin, Germany (T.S., M.S.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.)
| | - Ralf Dechend
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.).,HELIOS Klinikum, Department of Cardiology and Nephrology, Berlin, Germany (R.D.)
| | - Kristin Kräker
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
| | - Michaela Golic
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
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42
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Staff AC, Dechend R. Will Postnatal Renin-Angiotensin System Blockade Improve Long-Term Maternal Cardiovascular Health After Preeclampsia? Hypertension 2020; 76:1704-1706. [PMID: 33175632 DOI: 10.1161/hypertensionaha.120.16229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Anne Cathrine Staff
- From the Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway (A.C.S.).,Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway (A.C.S.)
| | - Ralf Dechend
- HELIOS Clinic, Berlin, Germany (R.D.).,Experimental and Clinical Research Center, Charité Medical Faculty and Max-Delbrueck Center for Molecular Medicine (R.D.)
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43
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Markó L, Park JK, Henke N, Rong S, Balogh A, Klamer S, Bartolomaeus H, Wilck N, Ruland J, Forslund SK, Luft FC, Dechend R, Müller DN. B-cell lymphoma/leukaemia 10 and angiotensin II-induced kidney injury. Cardiovasc Res 2020; 116:1059-1070. [PMID: 31241148 DOI: 10.1093/cvr/cvz169] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 06/07/2018] [Revised: 01/09/2019] [Accepted: 06/21/2019] [Indexed: 12/30/2022] Open
Abstract
AIMS B-cell lymphoma/leukaemia 10 (Bcl10) is a member of the CARMA-Bcl10-MALT1 signalosome, linking angiotensin (Ang) II, and antigen-dependent immune-cell activation to nuclear factor kappa-B signalling. We showed earlier that Bcl10 plays a role in Ang II-induced cardiac fibrosis and remodelling, independent of blood pressure. We now investigated the role of Bcl10 in Ang II-induced renal damage. METHODS AND RESULTS Bcl10 knockout mice (Bcl10 KO) and wild-type (WT) controls were given 1% NaCl in the drinking water and Ang II (1.44 mg/kg/day) for 14 days. Additionally, Bcl10 KO or WT kidneys were transplanted onto WT mice that were challenged by the same protocol for 7 days. Kidneys of Ang II-treated Bcl10 KO mice developed less fibrosis and showed fewer infiltrating cells. Nevertheless, neutrophil gelatinase-associated lipocalin (Ngal) and kidney injury molecule (Kim)1 expression was higher in the kidneys of Ang II-treated Bcl10 KO mice, indicating exacerbated tubular damage. Furthermore, albuminuria was significantly higher in Ang II-treated Bcl10 KO mice accompanied by reduced glomerular nephrin expression and podocyte number. Ang II-treated WT mice transplanted with Bcl10 KO kidney showed more albuminuria and renal Ngal, compared to WT- > WT kidney-transplanted mice, as well as lower podocyte number but similar fibrosis and cell infiltration. Interestingly, mice lacking Bcl10 in the kidney exhibited less Ang II-induced cardiac hypertrophy than controls. CONCLUSION Bcl10 has multi-faceted actions in Ang II-induced renal damage. On the one hand, global Bcl10 deficiency ameliorates renal fibrosis and cell infiltration; on the other hand, lack of renal Bcl10 aggravates albuminuria and podocyte damage. These data suggest that Bcl10 maintains podocyte integrity and renal function.
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Affiliation(s)
- Lajos Markó
- Experimental and Clinical Research Center, a cooperation of Charité - Universitätsmedizin Berlin, Berlin, Germany and Max Delbrück Center for Molecular Medicine, 13125 Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Song Rong
- Hannover Medical School, Hannover, Germany.,Transplantation Center, Zunyi Medical College, Zunyi, China
| | - András Balogh
- Experimental and Clinical Research Center, a cooperation of Charité - Universitätsmedizin Berlin, Berlin, Germany and Max Delbrück Center for Molecular Medicine, 13125 Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Samuel Klamer
- Experimental and Clinical Research Center, a cooperation of Charité - Universitätsmedizin Berlin, Berlin, Germany and Max Delbrück Center for Molecular Medicine, 13125 Berlin, Germany
| | - Hendrik Bartolomaeus
- Experimental and Clinical Research Center, a cooperation of Charité - Universitätsmedizin Berlin, Berlin, Germany and Max Delbrück Center for Molecular Medicine, 13125 Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,Charité-Universitätsmedizin Berlin, Berlin, Germany.,Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Nicola Wilck
- Experimental and Clinical Research Center, a cooperation of Charité - Universitätsmedizin Berlin, Berlin, Germany and Max Delbrück Center for Molecular Medicine, 13125 Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jürgen Ruland
- Institute of Clinical Chemistry and Pathobiochemistry, School of Medicine, Technical University of Munich, Munich, Germany.,Center for Translational Cancer Research (TranslaTUM), Munich, Germany.,German Cancer Consortium (DKTK), partner Site, Munich, Germany
| | - Sofia K Forslund
- Experimental and Clinical Research Center, a cooperation of Charité - Universitätsmedizin Berlin, Berlin, Germany and Max Delbrück Center for Molecular Medicine, 13125 Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,Charité-Universitätsmedizin Berlin, Berlin, Germany.,Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Friedrich C Luft
- Experimental and Clinical Research Center, a cooperation of Charité - Universitätsmedizin Berlin, Berlin, Germany and Max Delbrück Center for Molecular Medicine, 13125 Berlin, Germany.,Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Ralf Dechend
- Experimental and Clinical Research Center, a cooperation of Charité - Universitätsmedizin Berlin, Berlin, Germany and Max Delbrück Center for Molecular Medicine, 13125 Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,Charité-Universitätsmedizin Berlin, Berlin, Germany.,Helios Clinic Berlin-Buch, Berlin, Germany
| | - Dominik N Müller
- Experimental and Clinical Research Center, a cooperation of Charité - Universitätsmedizin Berlin, Berlin, Germany and Max Delbrück Center for Molecular Medicine, 13125 Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,Charité-Universitätsmedizin Berlin, Berlin, Germany.,Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
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44
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Muijsers HEC, Westermann D, Birukov A, van der Heijden OWH, Drost JT, Kräker K, Haase N, Müller DN, Herse F, Maas AHEM, Dechend R, Zeller T, Roeleveld N. High-sensitivity cardiac troponin I in women with a history of early-onset preeclampsia. J Hypertens 2020; 38:1948-1954. [PMID: 32890270 DOI: 10.1097/hjh.0000000000002497] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Preeclampsia is associated with an elevated risk of cardiovascular disease later in life. Women with a history of preeclampsia are at risk of developing hypertension as well as ischemic heart disease. Identification of women at the highest risk is important to initiate preventive strategies. We investigated whether high-sensitivity cardiac troponin I (hs-cTnI) levels are associated with a history of early-onset preeclampsia, and with hypertension in these high-risk women. METHODS Approximately 9-10 years after pregnancy, hs-cTnI levels were measured for 339 women of the Preeclampsia Risk Evaluation in FEMales cohort, consisting of 177 women with a history of early-onset preeclampsia and 162 women with a previous uncomplicated index pregnancy. Associations were analyzed using several statistical tests and linear regression analysis. RESULTS The median hs-cTnI levels (IQR) were 2.50 ng/l (2.30) in women with a history of early-onset preeclampsia and 2.35 ng/l (2.50) in women without a history of preeclampsia, P = 0.53. Among women with a history of early-onset preeclampsia, the hs-cTnI levels were higher in women who were hypertensive compared with their normotensive counterparts (medians 2.60 versus 2.30; P = 0.03). In addition, blood pressure levels increased with increasing hs-cTnI levels. CONCLUSION We did not find a difference in hs-cTnI levels between women with and without a history of early-onset preeclampsia. Nonetheless, hs-cTnI levels were statistically significantly higher in current hypertensive women with a history of preeclampsia compared with their normotensive counterparts. Therefore, hs-cTnI levels might improve risk prediction for women at the highest risk of cardiovascular disease.
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Affiliation(s)
- Hella E C Muijsers
- Radboud university medical center, Department of Cardiology, Nijmegen, The Netherlands
| | - Dirk Westermann
- Clinic for General and Interventional Cardiology, University Heart Center Hamburg, Hamburg
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lübeck/Kiel, Germany
| | - Anna Birukov
- Experimental and Clinical Research Center, a Joint Cooperation Between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
- German Center for Cardiovascular Research (DZKH), Partner Site Berlin
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association
- Berlin Institute of Health (BIH), Berlin, Germany
| | | | - José T Drost
- Saxenburgh Group, Department of Cardiology, Hardenberg
| | - Kristin Kräker
- Experimental and Clinical Research Center, a Joint Cooperation Between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
- German Center for Cardiovascular Research (DZKH), Partner Site Berlin
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Nadine Haase
- Experimental and Clinical Research Center, a Joint Cooperation Between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
- German Center for Cardiovascular Research (DZKH), Partner Site Berlin
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Dominik N Müller
- Experimental and Clinical Research Center, a Joint Cooperation Between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
- German Center for Cardiovascular Research (DZKH), Partner Site Berlin
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Florian Herse
- Experimental and Clinical Research Center, a Joint Cooperation Between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Angela H E M Maas
- Radboud university medical center, Department of Cardiology, Nijmegen, The Netherlands
| | - Ralf Dechend
- Experimental and Clinical Research Center, a Joint Cooperation Between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
- German Center for Cardiovascular Research (DZKH), Partner Site Berlin
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association
- Berlin Institute of Health (BIH), Berlin, Germany
- HELIOS Klinikum Berlin, Department of Cardiology and Nephrology, Berlin, Germany
| | - Tanja Zeller
- Clinic for General and Interventional Cardiology, University Heart Center Hamburg, Hamburg
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lübeck/Kiel, Germany
| | - Nel Roeleveld
- Radboud university medical center, Radboud Institute for Health Sciences, Department for Health Evidence, Nijmegen, The Netherlands
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45
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Limmroth V, Ziemssen T, Kleiter I, Wagner B, Schmidt S, Lassek C, Baier-Ebert M, Wendt G, Dechend R, Haverkamp W. A Comprehensive Monitoring Study on Electrocardiographic Assessments and Cardiac Events After Fingolimod First Dose-Possible Predictors of Cardiac Outcomes. Front Neurol 2020; 11:818. [PMID: 32903376 PMCID: PMC7434833 DOI: 10.3389/fneur.2020.00818] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 03/24/2020] [Accepted: 06/30/2020] [Indexed: 12/28/2022] Open
Abstract
Background: First dose observation for cardiac effects is required for fingolimod. Previous results in patients with relapsing remitting multiple sclerosis (RRMS) suggest that transient bradycardia and conduction abnormalities during the observation phase are rare, benign and reversible. Prior analyses corroborate these findings. The present large scale dataset allows subgroup analyses for differences in the incidence of cardiac findings depending on patient characteristics. Methods: START was an open-label, multi-center study that enrolled 6,998 RRMS patients. Primary endpoints were incidence of bradycardia (heart rate < 45 bpm) and second-/third-degree atrioventricular (AV) block during treatment initiation. Subgroup analyses were performed according to age, gender, body mass index (BMI), baseline expanded disability status scale (EDSS), and concomitant medication to determine the impact of these variables on cardiac outcomes parameters. Results: 63 patients (0.9%) developed bradycardia (<45 bpm), 120 patients (1.7%) had a second-degree Mobitz I (Wenkebach) block and/or 2:1 AV block. One case of an asymptomatic third-degree AV block occurred. No Mobitz II AV block was observed. After 1 week, no second-/third-degree AV block was observed. The incidence of second- or third-degree AV blocks was significantly higher in older patients (≥50 years; p = 0.014 vs. patients 35–49 years). Second- or third-degree AV blocks were more frequent in females (87.5% of all patients with a second- or third-degree AV block; p < 0.001), while bradycardia occurred more often in males (58.7% of all bradycardia events; p < 0.001). Furthermore, patients with a BMI below 25 had a higher incidence of second- or third-degree AV block. Conclusions: In summary, transient bradycardia and AV conduction abnormalities after the first dose of fingolimod were rare and asymptomatic. When compared to females, male patients might have a higher risk for bradycardia during treatment initiation, presumably due to a lower resting heart rate. Furthermore, a low heart rate before treatment initiation, low body weight, or low BMI possibly increases the risk for bradycardia. Second- or third-degree AV blocks were more frequent in females, older patients and patients with a low BMI. Nevertheless, these cardiac events remained rare and benign, confirming the favorable cardiac safety profile of fingolimod upon treatment initiation in MS patients without cardiovascular comorbidities.
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Affiliation(s)
- Volker Limmroth
- Department of Neurology, Cologne General Hospitals, University of Cologne, Cologne, Germany
| | - Tjalf Ziemssen
- Center of Clinical Neuroscience, University Clinic Carl Gustav Carus Dresden, Dresden, Germany
| | - Ingo Kleiter
- Department of Neurology, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany.,Marianne-Strauß-Klinik, Behandlungszentrum Kempfenhausen für Multiple Sklerose Kranke, Berg, Germany
| | | | - Stephan Schmidt
- Neurologische Gemeinschaftspraxis Schmidt, Neudecker, Viebahn und Kronenberger, Bonn, Germany
| | - Christoph Lassek
- Neurologische Gemeinschaftspraxis Kassel und Vellmar, Kassel, Germany
| | | | | | - Ralf Dechend
- Experimental and Clinical Research Center, Charité-Campus Buch and HELIOS Klinikum, Berlin, Germany
| | - Wilhelm Haverkamp
- Division for Metabolism and Cardiology, Department of Cardiology, Charité Universitaetsmedizin Berlin, Berlin, Germany
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46
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Marko L, Dörr A, Linz PR, H. van den Meiracker A, Kühne T, Dechend R, Danser JH, Flörcken A, Mueller DN. Abstract P180: Effect Of Sunitinib Treatment On Skin Sodium Accumulation In Patients With Metastatic Renal Cancer: A Pilot Study. Hypertension 2020. [DOI: 10.1161/hyp.76.suppl_1.p180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Angiogenesis is required for invasive tumor growth and metastasis which is controlled mainly by vascular endothelial growth factors (VEGF). Novel strategies for cancer treatment target VEGF signaling. These agents are featured by adverse events including hypertension. New concepts suggest that besides the kidneys, the skin also plays a role in body sodium homeostasis and blood pressure regulation by a VEGF-C–dependent buffering mechanism. Here, we tested the hypothesis that changes in blood pressure correspond to tissue sodium accumulation during sunitinib treatment of metastatic renal cell carcinoma patients (https://clinicaltrials.gov/identifier: NCT04368546; Charité ethical approval EA1/044/15).Male patients (n=4) took sunitinib according to the standard treatment protocol, 50 mg once daily, taken for 4 weeks followed by a 2-weeks off treatment period. Measurements were performed at baseline (before sunitinib treatment), and over a complete on-off-on period. Tissue sodium content was measured using non-invasive 23Na-MRI; skin sodium was measured in a group (n=5) of age-matched healthy subjects, as well. Blood pressure was measured according to AHA guidelines. Blood withdrawal followed after ca. 45 minutes of sitting to measure VEGF-A, VEGF-C, endothelin-1, renin and aldosterone levels.Elevated systolic blood pressure under sunitinib treatment decreased to the baseline level in the off-treatment phase (130.5 mmHg vs 117.5 mmHg, respectively, p<0.05). Plasma endothelin-1 levels mirrored directly and VEGF-A levels inversely the blood pressure changes. Baseline skin sodium content was similar to the skin sodium level of healthy controls. Skin sodium content was elevated after the first on-treatment phase and stayed high in all the following measurements in comparison to control subjects. Patients had high baseline VEGF-C levels that decreased after the first treatment with sunitinib and stayed low independently of further treatment phase.In conclusion, sunitinib treatment suppresses VEGF-C levels permanently which is associated with sustained elevated skin sodium levels. Furthermore, we confirmed the association between plasma endothelin-1 levels and blood pressure changes during sunitinib treatment protocol.
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Affiliation(s)
- Lajos Marko
- EXP. AND CLINICAL RESEARCH CENTER, Berlin, Germany
| | - Anne Dörr
- Med Dept, Div of Hematology, Oncology and Tumor Immunology, Charité - Universitätsmedizin Berlin, Germany, Berlin, Germany
| | | | - Anton H. van den Meiracker
- Div of Pharmacology and Vascular Medicine, Dept of Internal Medicine, Erasmus Med Cntr, Rotterdam, Netherlands
| | - Titus Kühne
- Institute for Cardiovascular Computer-assisted Medicine, Charité - Universitätsmedizin, Berlin, Germany
| | - Ralf Dechend
- Charite and Helios Clinic Berlin, Berlin, Germany
| | | | - Anne Flörcken
- Med Dept, Div of Hematology, Oncology and Tumor Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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47
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Kedziora SM, Kraeker K, Markó L, Mueller DN, Dechend R, Haase N, Herse F. Abstract P212: Kidney Injury Caused By Preeclamptic Pregnancy Improves Postpartum In A Transgenic Rat Model. Hypertension 2020. [DOI: 10.1161/hyp.76.suppl_1.p212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Preeclamptic pregnancies involve mild renal injuries. However, there has been evidence that women with a history of preeclampsia (PE) have an increased risk to develop kidney disease in association to high blood pressure later in life. This study aims to characterize renal injury during pregnancy and postpartum in an established transgenic rat model for PE. Female Sprague-Dawley rats transgenic for the human angiotensinogen gene develop a PE phenotype in pregnancy, including cardiac remodeling, when mated with male rats harboring the human renin gene. Postpartum, blood pressure restores but cardiac remodeling persists. We hypothesize that PE during pregnancy mediates kidney injuries but does not fully restore after ending of the high blood pressure (postpartum). The renal alterations were analyzed by histological staining, gene expression and urine analysis. PE rats have elevated mean arterial blood pressure during pregnancy (PE
d19
148.4 ± 20.7 mmHg) compared to normotensive values in control animals (WT
d19
105.3 ± 4.6 mmHg). During PE increased expression of
kidney injury marker 1
(
Kim-1/18S
: PE
d21
4.14 ± 3.26; WT
d21
0.08 ± 0.02),
neutrophil gelatinase associated lipocalin 2
(
Ngal/18S
: PE
d21
1.64 ± 0.83; WT
d21
0.59 ± 0.28) and
connective-tissue growth factor
(
Ctgf/18S:
PE
d21
1.51 ± 0.46; WT
d21
0.92 ± 0.32) were detected. Kidneys of PE rats showed mild glomerular (PAS-positive glomerular area PE
d21
86.2 ± 4.4%; WT
d21
79.1 ± 3.2%) and tubular changes during PE pregnancy resulting in albuminuria (albumin/creatinine ratio PE
d19
2193.8 ± 1878.2; WT
d19
290.4 ± 252.0). However, 4 weeks after pregnancy (approx. 2 years in humans) most of the PE related renal damages were absent including albuminuria and elevated expression of biomarkers (
Kim-1/18S
: PE
d50
0.09 ± 0.05; WT
d50
0.23 ± 0.13;
Ctgf/18S
: PE
d50
0.78 ± 0.25; WT
d50
0.8 ± 0.25;
Ngal/18S
: PE
d50
0.37 ± 0.17; WT
50
0.47 ± 0.11). Only mild enlargement of glomerular tuft area (PE
d50
7523.8
± 418.7 μm
2
; WT
d50
7058.4 ± 198.8 μm
2
) was detected. Overall, the glomerular and tubular injuries are present during pregnancy in this transgenic PE rat. Most restore postpartum, speculating long-term kidney failure observed in humans is associated to hypertension and additional cardiovascular events.
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Affiliation(s)
| | | | | | | | - Ralf Dechend
- Charite and Helios Clinic Berlin, Berlin, Germany
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48
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Moe K, Sugulle M, Dechend R, Angel K, Staff AC. Functional and structural vascular biomarkers in women 1 year after a hypertensive disorder of pregnancy. Pregnancy Hypertens 2020; 21:23-29. [DOI: 10.1016/j.preghy.2020.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 11/17/2022]
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49
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Birukov A, Herse F, Nielsen JH, Kyhl HB, Golic M, Kräker K, Haase N, Busjahn A, Bruun S, Jensen BL, Müller DN, Jensen TK, Christesen HT, Andersen MS, Jørgensen JS, Dechend R, Andersen LB. Blood Pressure and Angiogenic Markers in Pregnancy: Contributors to Pregnancy-Induced Hypertension and Offspring Cardiovascular Risk. Hypertension 2020; 76:901-909. [PMID: 32507044 DOI: 10.1161/hypertensionaha.119.13966] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Pregnancy-induced hypertension is a severe pregnancy complication, increasing risk of long-term cardiovascular disease in mothers and offspring. We hypothesized that maternal blood pressure in pregnancy associated with offspring blood pressure; that the associations were sex-specific; and that maternal circulating placental angiogenic markers (PlGF [placental growth factor] and sFlt-1 [soluble fms-like tyrosine kinase-1]) mediated this relationship. We analyzed data from 2434 women and 2217 children from the Odense Child Cohort, a prospective Danish cohort study. Offspring blood pressure trajectory from 4 months to 5 years was highly associated to maternal first, second, and third trimester blood pressure, and mean blood pressure in pregnancy, independent of maternal and offspring covariates. There were offspring sex-specific associations: Girls from mothers in the highest quartile of first and third trimester blood pressure had significantly higher systolic blood pressure at 5 years than the rest of the cohort (mean difference±SEM: 1.81±0.59 and 2.11±0.59 mm Hg, respectively, all P<0.01); whereas boys had significantly higher diastolic blood pressure at 5 years (mean difference±SEM: 1.11±0.45 and 1.03±0.45, respectively, all P<0.05). Concentrations of PlGF at gestational week 28 correlated inversely to maternal gestational blood pressure trajectory, independent of the diagnosis of pregnancy-induced hypertension, adjusted β coefficients (95% CI) for predicting systolic blood pressure (SBP): -3.18 (-4.66 to -1.70) mm Hg, for predicting diastolic blood pressure (DBP): -2.48 (-3.57 to -1.40) mm Hg. In conclusion, maternal gestational blood pressure predicted offspring blood pressure trajectory until 5 years in a sex-differential manner. Furthermore, subtle alterations in blood pressure in early pregnancy preceded hypertension or preeclampsia, and PlGF was a mediator of cardiovascular health in pregnancy.
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Affiliation(s)
- Anna Birukov
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (A. Birukov, K.K., N.H., D.N.M., R.D.).,Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark (A. Birukov, J.S.J., L.B.A.).,Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany (A. Birukov)
| | - Florian Herse
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.)
| | - Julie H Nielsen
- Department of Endocrinology and Metabolism, Odense University Hospital, Denmark (J.H.N., M.S.A.)
| | - Henriette B Kyhl
- Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (H.B.K., T.K.J., H.T.C., J.S.J.).,OPEN Patient data Explorative Network, Odense University Hospital, Denmark (H.B.K., S.B., H.T.C., J.S.J.)
| | - Michaela Golic
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.)
| | - Kristin Kräker
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (A. Birukov, K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.)
| | - Nadine Haase
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (A. Birukov, K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.)
| | | | - Signe Bruun
- OPEN Patient data Explorative Network, Odense University Hospital, Denmark (H.B.K., S.B., H.T.C., J.S.J.).,Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (S.B., H.T.C.).,Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (S.B., H.T.C., J.S.J., L.B.A.).,Strategic Business Unit Pediatric, Arla Foods Ingredients Group P/S, Viby J, Denmark (S.B.)
| | - Boye L Jensen
- Institute for Molecular Medicine, University of Southern Denmark, Odense, Denmark (B.L.J.)
| | - Dominik N Müller
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (A. Birukov, K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.)
| | - Tina Kold Jensen
- Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (H.B.K., T.K.J., H.T.C., J.S.J.).,Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark (T.K.J.)
| | - Henrik T Christesen
- Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (H.B.K., T.K.J., H.T.C., J.S.J.).,OPEN Patient data Explorative Network, Odense University Hospital, Denmark (H.B.K., S.B., H.T.C., J.S.J.).,Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (S.B., H.T.C.).,Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (S.B., H.T.C., J.S.J., L.B.A.)
| | | | - Jan Stener Jørgensen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark (A. Birukov, J.S.J., L.B.A.).,Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (H.B.K., T.K.J., H.T.C., J.S.J.).,OPEN Patient data Explorative Network, Odense University Hospital, Denmark (H.B.K., S.B., H.T.C., J.S.J.).,Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (S.B., H.T.C., J.S.J., L.B.A.)
| | - Ralf Dechend
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (A. Birukov, K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.).,Department of Cardiology and Nephrology, HELIOS-Klinikum, Berlin, Germany (R.D.)
| | - Louise Bjørkholt Andersen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark (A. Birukov, J.S.J., L.B.A.).,Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (S.B., H.T.C., J.S.J., L.B.A.).,Department of Obstetrics and Gynecology, Herlev Hospital, Denmark (L.B.A.)
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50
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Obradovic D, Loncar G, Radenovic S, Tahirovic E, Heidecke H, Schulze-Forster K, Muller D, Busjahn A, Buttner P, Veskovic J, Zdravkovic M, Li H, Li S, Savkovic V, Pieske B, Dungen HD, Dechend R. Soluble (pro)renin receptor in elderly chronic heart failure patients. Front Biosci (Landmark Ed) 2020; 25:1839-1853. [PMID: 32472760 DOI: 10.2741/4880] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Overactivation of renin-angiotensin system (RAS) is one of the main pathophysiological features in the evolution of chronic heart failure (CHF). The (pro)renin receptor ((P)RR) represents an important player in a tissue renin-angiotensin system (tissue RAS), which mediates tissue injury through fibrosis and hypertrophy of the affected organs in CHF patients. In our study we used plasma samples from 556 elderly subjects with CHF and 198 healthy participants in order to evaluate prognostic and diagnostic potential of s(P)RR in setting of CHF. The patients with CHF showed significantly higher plasma levels of s(P)RR than the healthy volunteers (p=0.0005). We observed association between higher s(P)RR plasma concentrations and lower left ventricular ejection fraction and higher degree of left ventricular dilatation on baseline echocardiography examination of the CHF patients. Elderly CHF patients with higher baseline s(P)RR plasma concentration were at same risk for death, stroke and hospitalization due to heart failure worsening at mean follow-up from forty-eight months in comparison to low s(P)RR counterparts.
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Affiliation(s)
- Danilo Obradovic
- Department of Cardiology-Internal Medicine, Heart Center Leipzig, University Leipzig, Leipzig 04289,
| | - Goran Loncar
- Institute for Cardiovascular Diseases "Dedinje", University of Belgrade, Belgrade 11040
| | - Sara Radenovic
- Department of Cardiology Campus Virchow, Charite Universitatsmedizin Berlin, Berlin 13353
| | - Elvis Tahirovic
- Charite - Universitatsmedizin Berlin, Campus Virchow Klinikum, Department of Internal Medicine - Cardiology, Berlin, Germany, and DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
| | | | | | - Dominik Muller
- Experimental and Clinical Research Center, a joint cooperation between Max-Delbruck-Center for Molecular Medicine and Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin, Germany
| | - Andreas Busjahn
- HealthTwist GmbH, Biomedizinischer Forschungscampus Berlin-Buch, Germany
| | - Petra Buttner
- Department of Cardiology-Internal Medicine, Heart Center Leipzig, University Leipzig, Leipzig 04289
| | - Jovan Veskovic
- Department of Cardiology Campus Virchow, Charite Universitatsmedizin Berlin, Berlin 13353
| | - Marija Zdravkovic
- Department of Cardiology, University Clinical Hospital "Bezanijska Kosa", University of Belgrade, Belgrade 11000
| | - Haluo Li
- Saxon Incubator for Clinical Translation, University Leipzig, Leipzig 04103
| | - Simin Li
- Saxon Incubator for Clinical Translation, University Leipzig, Leipzig 04103
| | - Vuk Savkovic
- Saxon Incubator for Clinical Translation, University Leipzig, Leipzig 04103
| | - Burkert Pieske
- Charite - Universitatsmedizin Berlin, Campus Virchow Klinikum, Department of Internal Medicine - Cardiology, Berlin, Germany, and DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
| | - Hans-Dirk Dungen
- Charite - Universitatsmedizin Berlin, Campus Virchow Klinikum, Department of Internal Medicine - Cardiology, Berlin, Germany, and DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
| | - Ralf Dechend
- Experimental and Clinical Research Center, Max Delbruck Center for Molecular Medicine, Berlin 13125
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