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Takeda S, Emoto T, Yamashita T, Yamamoto H, Takaya T, Sawada T, Yoshida T, Inoue M, Suzuki Y, Hamana T, Inoue T, Taniguchi M, Sasaki N, Otake H, Ohkawa T, Furuyashiki T, Kawai H, Hirata KI. Single-Cell RNA Sequencing Reveals an Immune Landscape of CD4 + T Cells in Coronary Culprit Plaques With Acute Coronary Syndrome in Humans-Brief Report. Arterioscler Thromb Vasc Biol 2024; 44:1135-1143. [PMID: 38572648 DOI: 10.1161/atvbaha.123.320409] [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: 11/09/2023] [Accepted: 03/11/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Acute coronary syndrome (ACS) involves plaque-related thrombosis, causing primary ischemic cardiomyopathy or lethal arrhythmia. We previously demonstrated a unique immune landscape of myeloid cells in the culprit plaques causing ACS by using single-cell RNA sequencing. Here, we aimed to characterize T cells in a single-cell level, assess clonal expansion of T cells, and find a therapeutic target to prevent ACS. METHODS We obtained the culprit lesion plaques from 4 patients with chronic coronary syndrome (chronic coronary syndrome plaques) and the culprit lesion plaques from 3 patients with ACS (ACS plaques) who were candidates for percutaneous coronary intervention with directional coronary atherectomy. Live CD45+ immune cells were sorted from each pooled plaque samples and applied to the 10× platform for single-cell RNA sequencing analysis. We also extracted RNA from other 3 ACS plaque samples and conducted unbiased TCR (T-cell receptor) repertoire analysis. RESULTS CD4+ T cells were divided into 5 distinct clusters: effector, naive, cytotoxic, CCR7+ (C-C chemokine receptor type 7) central memory, and FOXP3 (forkhead box P3)+ regulatory CD4+ T cells. The proportion of central memory CD4+ T cells was higher in the ACS plaques. Correspondingly, dendritic cells also tended to express more HLAs (human leukocyte antigens) and costimulatory molecules in the ACS plaques. The velocity analysis suggested the differentiation flow from central memory CD4+ T cells into effector CD4+ T cells and that from naive CD4+ T cells into central memory CD4+ T cells in the ACS plaques, which were not observed in the chronic coronary syndrome plaques. The bulk repertoire analysis revealed clonal expansion of TCRs in each patient with ACS and suggested that several peptides in the ACS plaques work as antigens and induced clonal expansion of CD4+ T cells. CONCLUSIONS For the first time, we revealed single cell-level characteristics of CD4+ T cells in patients with ACS. CD4+ T cells could be therapeutic targets of ACS. REGISTRATION URL: https://upload.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000046521; Unique identifier: UMIN000040747.
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Affiliation(s)
- Shintaro Takeda
- Division of Cardiovascular Medicine, Department of Internal Medicine (S.T., T.E., T. Yamashita, Y.S., T.H., H.O., K.-i.H.), Kobe University Graduate School of Medicine, Japan
| | - Takuo Emoto
- Division of Cardiovascular Medicine, Department of Internal Medicine (S.T., T.E., T. Yamashita, Y.S., T.H., H.O., K.-i.H.), Kobe University Graduate School of Medicine, Japan
| | - Tomoya Yamashita
- Division of Cardiovascular Medicine, Department of Internal Medicine (S.T., T.E., T. Yamashita, Y.S., T.H., H.O., K.-i.H.), Kobe University Graduate School of Medicine, Japan
- Division of Advanced Medical Science, Kobe University Graduate School of Science, Technology and Innovation, Japan (T. Yamashita)
| | - Hiroyuki Yamamoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Hyogo Prefectural Harima-Himeji General Medical Center, Japan (H.Y., T.T., H.K.)
| | - Tomofumi Takaya
- Division of Cardiovascular Medicine, Department of Exploratory and Advanced Search in Cardiology (T.T., H.K.), Kobe University Graduate School of Medicine, Japan
- Division of Cardiovascular Medicine, Department of Internal Medicine, Hyogo Prefectural Harima-Himeji General Medical Center, Japan (H.Y., T.T., H.K.)
| | - Takahiro Sawada
- Division of Cardiovascular Medicine, Kakogawa City Hospital, Japan (T.S.)
| | - Takeshi Yoshida
- Department of Information and Intelligence Engineering, Kobe University, Japan (T. Yoshida, M.I., T.O.)
| | - Masatoshi Inoue
- Department of Information and Intelligence Engineering, Kobe University, Japan (T. Yoshida, M.I., T.O.)
| | - Yuya Suzuki
- Division of Cardiovascular Medicine, Department of Internal Medicine (S.T., T.E., T. Yamashita, Y.S., T.H., H.O., K.-i.H.), Kobe University Graduate School of Medicine, Japan
| | - Tomoyo Hamana
- Division of Cardiovascular Medicine, Department of Internal Medicine (S.T., T.E., T. Yamashita, Y.S., T.H., H.O., K.-i.H.), Kobe University Graduate School of Medicine, Japan
| | - Taishi Inoue
- Department of Cardiovascular Surgery (T.I.), Kobe University Graduate School of Medicine, Japan
| | - Masayuki Taniguchi
- Division of Pharmacology (M.T., T.F.), Kobe University Graduate School of Medicine, Japan
| | - Naoto Sasaki
- Laboratory of Medical Pharmaceutics, Kobe Pharmaceutical University, Japan (N.S.)
| | - Hiromasa Otake
- Division of Cardiovascular Medicine, Department of Internal Medicine (S.T., T.E., T. Yamashita, Y.S., T.H., H.O., K.-i.H.), Kobe University Graduate School of Medicine, Japan
| | - Takenao Ohkawa
- Department of Information and Intelligence Engineering, Kobe University, Japan (T. Yoshida, M.I., T.O.)
| | - Tomoyuki Furuyashiki
- Division of Pharmacology (M.T., T.F.), Kobe University Graduate School of Medicine, Japan
| | - Hiroya Kawai
- Division of Cardiovascular Medicine, Department of Exploratory and Advanced Search in Cardiology (T.T., H.K.), Kobe University Graduate School of Medicine, Japan
- Division of Cardiovascular Medicine, Department of Internal Medicine, Hyogo Prefectural Harima-Himeji General Medical Center, Japan (H.Y., T.T., H.K.)
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine (S.T., T.E., T. Yamashita, Y.S., T.H., H.O., K.-i.H.), Kobe University Graduate School of Medicine, Japan
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Zhang H, Cai J, Zhang R, Shuai S, Tang M, Ju R, Hu Y, Zuo T, Yang Y. The role of serum lipid in predicting coronary artery lesions and intravenous immunoglobulin resistance in Kawasaki disease: a cohort study. J Int Med Res 2024; 52:3000605241252115. [PMID: 38713460 PMCID: PMC11080733 DOI: 10.1177/03000605241252115] [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: 02/03/2024] [Accepted: 04/15/2024] [Indexed: 05/08/2024] Open
Abstract
OBJECTIVE To assess the predictive value of the serum lipid profile for initial intravenous immunoglobulin (IVIG) resistance and coronary artery lesions (CALs) in patients with Kawasaki disease (KD). METHODS This retrospective cohort study enrolled patients with KD and divided them into IVIG-responsive and IVIG-resistant groups. They were also stratified based on the presence of CALs (CALs and non-CALs groups). Clinical, echocardiographic and biochemical values were evaluated. A subgroup analysis was performed on complete and incomplete KD. Predictors of initial IVIG resistance and CALs were determined by multivariate logistic regression analysis. RESULTS A total of 649 KD patients were enrolled: 151 had CALs and 76 had initial IVIG resistance. Low-density lipoprotein cholesterol (LDL-C) was significantly lower in the IVIG-resistant group than in the IVIG-responsive group. LDL-C and apolipoprotein (Apo) B were significantly lower in the CALs group compared with the non-CALs group. Multivariate logistic regression failed to identify the serum lipid profile (LDL-C, Apo A or Apo B) as an independent risk factor for initial IVIG resistance or CALs in KD patients. CONCLUSION KD patients might have dyslipidaemia in the acute phase, but the serum lipid profile might not be suitable as a single predictor for initial IVIG resistance or CALs.
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Affiliation(s)
- Hongxi Zhang
- Department of Pharmacy, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Jianghui Cai
- Department of Pharmacy, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
- Department of Pharmacy, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Rui Zhang
- Department of Pharmacy, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Shuping Shuai
- Department of Pharmacy, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Mi Tang
- Department of Pharmacy, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
- Office of Good Clinical Practice, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Rong Ju
- Department of Paediatrics, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Ying Hu
- Department of Pharmacy, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Tianrui Zuo
- Department of Pharmacy, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Yanfeng Yang
- Department of Paediatrics, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
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Chowdhury RR, D’Addabbo J, Huang X, Veizades S, Sasagawa K, Louis DM, Cheng P, Sokol J, Jensen A, Tso A, Shankar V, Wendel BS, Bakerman I, Liang G, Koyano T, Fong R, Nau A, Ahmad H, Gopakumar JK, Wirka R, Lee A, Boyd J, Joseph Woo Y, Quertermous T, Gulati G, Jaiswal S, Chien YH, Chan C, Davis MM, Nguyen PK. Human Coronary Plaque T Cells Are Clonal and Cross-React to Virus and Self. Circ Res 2022; 130:1510-1530. [PMID: 35430876 PMCID: PMC9286288 DOI: 10.1161/circresaha.121.320090] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Coronary artery disease is an incurable, life-threatening disease that was once considered primarily a disorder of lipid deposition. Coronary artery disease is now also characterized by chronic inflammation' notable for the buildup of atherosclerotic plaques containing immune cells in various states of activation and differentiation. Understanding how these immune cells contribute to disease progression may lead to the development of novel therapeutic strategies. METHODS We used single-cell technology and in vitro assays to interrogate the immune microenvironment of human coronary atherosclerotic plaque at different stages of maturity. RESULTS In addition to macrophages, we found a high proportion of αβ T cells in the coronary plaques. Most of these T cells lack high expression of CCR7 and L-selectin, indicating that they are primarily antigen-experienced memory cells. Notably, nearly one-third of these cells express the HLA-DRA surface marker, signifying activation through their TCRs (T-cell receptors). Consistent with this, TCR repertoire analysis confirmed the presence of activated αβ T cells (CD4<CD8), exhibiting clonal expansion of specific TCRs. Interestingly, we found that these plaque T cells had TCRs specific for influenza, coronavirus, and other viral epitopes, which share sequence homologies to proteins found on smooth muscle cells and endothelial cells, suggesting potential autoimmune-mediated T-cell activation in the absence of active infection. To better understand the potential function of these activated plaque T cells, we then interrogated their transcriptome at the single-cell level. Of the 3 T-cell phenotypic clusters with the highest expression of the activation marker HLA-DRA, 2 clusters expressed a proinflammatory and cytolytic signature characteristic of CD8 cells, while the other expressed AREG (amphiregulin), which promotes smooth muscle cell proliferation and fibrosis, and, thus, contributes to plaque progression. CONCLUSIONS Taken together, these findings demonstrate that plaque T cells are clonally expanded potentially by antigen engagement, are potentially reactive to self-epitopes, and may interact with smooth muscle cells and macrophages in the plaque microenvironment.
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Affiliation(s)
- Roshni Roy Chowdhury
- Department of Microbiology and Immunology, Stanford University
- Department of Medicine (Section of Genetic Medicine), University of Chicago
| | - Jessica D’Addabbo
- Department of Medicine (Cardiovascular Medicine), Stanford University
| | - Xianxi Huang
- The First Affiliated Hospital of Shantou University Medical College
- Stanford Cardiovascular Institute, Stanford University
| | - Stefan Veizades
- Department of Medicine (Cardiovascular Medicine), Stanford University
- Stanford Cardiovascular Institute, Stanford University
- Edinburgh Medical School, United Kingdom
| | - Koki Sasagawa
- Department of Medicine (Cardiovascular Medicine), Stanford University
| | | | - Paul Cheng
- Department of Medicine (Cardiovascular Medicine), Stanford University
- Stanford Cardiovascular Institute, Stanford University
| | - Jan Sokol
- Department of Medicine (Cardiovascular Medicine), Stanford University
- Stanford Cardiovascular Institute, Stanford University
| | - Annie Jensen
- Department of Medicine (Cardiovascular Medicine), Stanford University
- Stanford Cardiovascular Institute, Stanford University
- Institute for Immunity, Transplantation and Infection, Stanford University
| | - Alexandria Tso
- Department of Medicine (Cardiovascular Medicine), Stanford University
- Stanford Cardiovascular Institute, Stanford University
- Institute for Immunity, Transplantation and Infection, Stanford University
| | - Vishnu Shankar
- Institute for Immunity, Transplantation and Infection, Stanford University
| | - Ben Shogo Wendel
- Institute for Immunity, Transplantation and Infection, Stanford University
| | - Isaac Bakerman
- Department of Medicine (Cardiovascular Medicine), Stanford University
- Stanford Cardiovascular Institute, Stanford University
| | - Grace Liang
- Department of Medicine (Cardiovascular Medicine), Stanford University
- Stanford Cardiovascular Institute, Stanford University
| | - Tiffany Koyano
- Department of Cardiothoracic Surgery, Stanford University
| | - Robyn Fong
- Department of Cardiothoracic Surgery, Stanford University
| | - Allison Nau
- Department of Microbiology and Immunology, Stanford University
| | - Herra Ahmad
- Department of Pathology, Stanford University
| | | | - Robert Wirka
- Department of Medicine (Cardiovascular Medicine), Stanford University
| | - Andrew Lee
- Stanford Cardiovascular Institute, Stanford University
- Department of Pathology, Stanford University
- Institute for Cancer Research, Shenzhen Bay Laboratory, Shenzhen, 518055, China
| | - Jack Boyd
- Department of Surgery, Stanford University
| | | | - Thomas Quertermous
- Department of Medicine (Cardiovascular Medicine), Stanford University
- Stanford Cardiovascular Institute, Stanford University
| | - Gunsagar Gulati
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University
| | | | - Yueh-Hsiu Chien
- Department of Microbiology and Immunology, Stanford University
| | - Charles Chan
- Stanford Cardiovascular Institute, Stanford University
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University
| | - Mark M. Davis
- Department of Microbiology and Immunology, Stanford University
- Edinburgh Medical School, United Kingdom
- Howard Hughes Medical Institute, Stanford University
| | - Patricia K. Nguyen
- Department of Medicine (Cardiovascular Medicine), Stanford University
- Stanford Cardiovascular Institute, Stanford University
- Institute for Immunity, Transplantation and Infection, Stanford University
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Yu Z, Zekavat SM, Haidermota S, Bernardo R, MacDonald BT, Libby P, Finucane HK, Natarajan P. Genome-wide pleiotropy analysis of coronary artery disease and pneumonia identifies shared immune pathways. Sci Adv 2022; 8:eabl4602. [PMID: 35452290 PMCID: PMC9032941 DOI: 10.1126/sciadv.abl4602] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
Coronary artery disease (CAD) remains the leading cause of death despite scientific advances. Elucidating shared CAD/pneumonia pathways may reveal novel insights regarding CAD pathways. We performed genome-wide pleiotropy analyses of CAD and pneumonia, examined the causal effects of the expression of genes near independently replicated SNPs and interacting genes with CAD and pneumonia, and tested interactions between disruptive coding mutations of each pleiotropic gene and smoking status on CAD and pneumonia risks. Identified pleiotropic SNPs were annotated to ADAMTS7 and IL6R. Increased ADAMTS7 expression across tissues consistently showed decreased risk for CAD and increased risk for pneumonia; increased IL6R expression showed increased risk for CAD and decreased risk for pneumonia. We similarly observed opposing CAD/pneumonia effects for NLRP3. Reduced ADAMTS7 expression conferred a reduced CAD risk without increased pneumonia risk only among never-smokers. Genetic immune-inflammatory axes of CAD linked to respiratory infections implicate ADAMTS7 and IL6R, and related genes.
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Affiliation(s)
- Zhi Yu
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
| | | | - Sara Haidermota
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Rachel Bernardo
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Bryan T. MacDonald
- Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Peter Libby
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Hilary K. Finucane
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Pradeep Natarajan
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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5
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Sagris M, Theofilis P, Antonopoulos AS, Oikonomou E, Paschaliori C, Galiatsatos N, Tsioufis K, Tousoulis D. Inflammation in Coronary Microvascular Dysfunction. Int J Mol Sci 2021; 22:ijms222413471. [PMID: 34948272 PMCID: PMC8703507 DOI: 10.3390/ijms222413471] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [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: 11/08/2021] [Revised: 12/05/2021] [Accepted: 12/07/2021] [Indexed: 02/07/2023] Open
Abstract
Chronic low-grade inflammation is involved in coronary atherosclerosis, presenting multiple clinical manifestations ranging from asymptomatic to stable angina, acute coronary syndrome, heart failure and sudden cardiac death. Coronary microvasculature consists of vessels with a diameter less than 500 μm, whose potential structural and functional abnormalities can lead to inappropriate dilatation and an inability to meet the required myocardium oxygen demands. This review focuses on the pathogenesis of coronary microvascular dysfunction and the capability of non-invasive screening methods to detect the phenomenon. Anti-inflammatory agents, such as statins and immunomodulators, including anakinra, tocilizumab, and tumor necrosis factor-alpha inhibitors, have been assessed recently and may constitute additional or alternative treatment approaches to reduce cardiovascular events in atherosclerotic heart disease characterized by coronary microvascular dysfunction.
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Affiliation(s)
- Marios Sagris
- Cardiology Clinic, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (A.S.A.); (E.O.); (C.P.); (N.G.); (K.T.); (D.T.)
- Correspondence: ; Tel.:+30-213-2088099; Fax: +30-213-2088676
| | - Panagiotis Theofilis
- Cardiology Clinic, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (A.S.A.); (E.O.); (C.P.); (N.G.); (K.T.); (D.T.)
| | - Alexios S. Antonopoulos
- Cardiology Clinic, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (A.S.A.); (E.O.); (C.P.); (N.G.); (K.T.); (D.T.)
| | - Evangelos Oikonomou
- Cardiology Clinic, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (A.S.A.); (E.O.); (C.P.); (N.G.); (K.T.); (D.T.)
- Department of Cardiology, “Sotiria” Thoracic Diseases Hospital of Athens, University of Athens Medical School, 11527 Athens, Greece
| | - Christina Paschaliori
- Cardiology Clinic, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (A.S.A.); (E.O.); (C.P.); (N.G.); (K.T.); (D.T.)
| | - Nikolaos Galiatsatos
- Cardiology Clinic, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (A.S.A.); (E.O.); (C.P.); (N.G.); (K.T.); (D.T.)
| | - Kostas Tsioufis
- Cardiology Clinic, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (A.S.A.); (E.O.); (C.P.); (N.G.); (K.T.); (D.T.)
| | - Dimitris Tousoulis
- Cardiology Clinic, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (A.S.A.); (E.O.); (C.P.); (N.G.); (K.T.); (D.T.)
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Pober JS, Chih S, Kobashigawa J, Madsen JC, Tellides G. Cardiac allograft vasculopathy: current review and future research directions. Cardiovasc Res 2021; 117:2624-2638. [PMID: 34343276 PMCID: PMC8783389 DOI: 10.1093/cvr/cvab259] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/02/2021] [Accepted: 07/29/2021] [Indexed: 12/25/2022] Open
Abstract
Cardiac allograft vasculopathy (CAV) is a pathologic immune-mediated remodelling of the vasculature in transplanted hearts and, by impairing perfusion, is the major cause of late graft loss. Although best understood following cardiac transplantation, similar forms of allograft vasculopathy occur in other vascularized organ grafts and some features of CAV may be shared with other immune-mediated vasculopathies. Here, we describe the incidence and diagnosis, the nature of the vascular remodelling, immune and non-immune contributions to pathogenesis, current therapies, and future areas of research in CAV.
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MESH Headings
- Adaptive Immunity
- Animals
- Coronary Artery Disease/epidemiology
- Coronary Artery Disease/immunology
- Coronary Artery Disease/metabolism
- Coronary Artery Disease/pathology
- Coronary Vessels/immunology
- Coronary Vessels/metabolism
- Coronary Vessels/pathology
- Endothelial Cells/immunology
- Endothelial Cells/metabolism
- Endothelial Cells/pathology
- Graft Rejection/epidemiology
- Graft Rejection/immunology
- Graft Rejection/metabolism
- Graft Rejection/pathology
- Graft Survival
- Heart Transplantation/adverse effects
- Humans
- Immunity, Innate
- Muscle, Smooth, Vascular/immunology
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Myocytes, Smooth Muscle/immunology
- Myocytes, Smooth Muscle/metabolism
- Myocytes, Smooth Muscle/pathology
- Risk Factors
- Signal Transduction
- Treatment Outcome
- Vascular Remodeling
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Affiliation(s)
- Jordan S Pober
- Department of Immunobiology, Pathology and Dermatology, Yale School of Medicine, 10 Amistad Street, New Haven CT 06520-8089, USA
| | - Sharon Chih
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Jon Kobashigawa
- Department of Medicine, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA
| | - Joren C Madsen
- Division of Cardiac Surgery and Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - George Tellides
- Department of Surgery (Cardiac Surgery), Yale School of Medicine, New Haven, CT, USA
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Almuwaqqat Z, Kim JH, Garcia M, Ko YA, Moazzami K, Lima B, Sullivan S, Alkhalaf J, Mehta A, Shah AJ, Hussain MS, Pearce BD, Bremner JD, Waller EK, Vaccarino V, Quyyumi AA. Associations Between Inflammation, Cardiovascular Regenerative Capacity, and Cardiovascular Events: A Cohort Study. Arterioscler Thromb Vasc Biol 2021; 41:2814-2822. [PMID: 34551591 PMCID: PMC8675629 DOI: 10.1161/atvbaha.121.316574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/20/2021] [Accepted: 09/01/2021] [Indexed: 12/21/2022]
Abstract
Objective Circulating progenitor cells possess immune modulatory properties and might mitigate inflammation that is characteristic of patients with coronary artery disease. We hypothesized that patients with fewer circulating progenitor cells (CPCs) will have higher inflammatory markers and worse outcomes. Approach and Results Patients with stable coronary artery disease were enrolled in a prospective study enumerating CPCs as CD (cluster of differentiation)-34-expressing mononuclear cells (CD34+) and inflammation as levels of IL (interleukin)-6 and high-sensitivity CRP (C-reactive protein) levels. Patients were followed for 5 years for the end points of death and myocardial infarction with repeat inflammatory biomarkers measured after a median of 2 years. In the entire cohort of 392 patients, IL-6 and high-sensitivity CRP levels remained unchanged (0.3+/-2.4 pg/mL and 0.1+/-1.0 mg/L; P=0.45) after 2 years. CPC counts (log-transformed) were inversely correlated with the change in IL-6 levels (r, -0.17; P<0.001). Using linear regression, IL-6 and high-sensitivity CRP levels declined by -0.59 (95% CI, -0.90 to -0.20) pg/mL and -0.13 (-0.28 to 0.01) mg/L per 1 log higher CPC counts after adjustment for the demographic and clinical variables, as well as medications. Using Cox models adjusted for these risk factors, a rise in 1 pg/mL of IL-6 was associated with a 11% (95% CI, 9-13) greater risk of death/myocardial infarction. We found that the change in IL6 level partly (by 40%) mediated the higher risk of adverse events among those with low CPC counts. Conclusions Reduced cardiovascular regenerative capacity is independently associated with progressive inflammation in patients with coronary artery disease that in turn is associated with poor outcomes.
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Affiliation(s)
- Zakaria Almuwaqqat
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Jeong Hwan Kim
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Mariana Garcia
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Yi-An Ko
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Kasra Moazzami
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Bruno Lima
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Samaah Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Jamil Alkhalaf
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Anurag Mehta
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
| | - Amit J. Shah
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
- Atlanta VA Medical Center, Decatur, Georgia
| | - Mohammad S. Hussain
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
| | - Brad D. Pearce
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - J. Douglas Bremner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
- Atlanta VA Medical Center, Decatur, Georgia
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
| | - Edmund K. Waller
- Department of Hematology and Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Viola Vaccarino
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Arshed A. Quyyumi
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
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8
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Teodorovich N, Jonas M, Haberman D, Abu Khadija H, Ayyad O, Gandelman G, Poles L, George J, Blatt A. Natural Anti-Endothelial Cell Antibodies in Patients Undergoing Coronary Angiography. Isr Med Assoc J 2021; 23:657-661. [PMID: 34672449] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Anti-endothelial cell antibodies (AECA) are a known biomarker of endothelial dysfunction and damage in clinical practice, especially in autoimmune disease. OBJECTIVES To determine the relation between natural AECA levels and prognosis related to coronary artery disease. METHODS Candidates for coronary angiography were prospectively enrolled. AECA levels were determined by ELISA assay. Mortality was evaluated after more than 5 years follow-up. RESULTS Of a total 857 patients, 445 had high AECA levels (group 1) and 412 had low levels (< 1 OD unit, group 2). Both groups did not differ in age, sex, or presence of diabetes. The median follow up was 2293 days (76 months). Patients with high AECA levels were more likely to have normal coronary arteries on angiography (21.6% vs. 16.9%, P = 0.047) and less likely to have calcified lesions (19.0% vs. 26.6%, P = 0.028) and lower prevalence of abnormal renal functions (71.1 mg/dl vs. 66.5 mg/dl, P = 0.033). Patients with higher AECA levels had lower mortality levels (20.1% vs. 27.6%, P = 0.006). A logistic regression model demonstrated independent association between lower AECA levels and the presence of coronary atherosclerosis based on angiogram. CONCLUSIONS After a median of more than 6 years, higher natural AECA levels were associated with less coronary artery disease and lower mortality rates in patients undergoing coronary angiography.
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Affiliation(s)
- Nicholay Teodorovich
- Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Michael Jonas
- Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Dan Haberman
- Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Haitham Abu Khadija
- Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Omar Ayyad
- Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Gera Gandelman
- Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Lion Poles
- Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Jacob George
- Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Alex Blatt
- Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
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9
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Liu C, Yang D, Wang H, Hu S, Xie X, Zhang L, Jia H, Qi Q. MicroRNA-197-3p mediates damage to human coronary artery endothelial cells via targeting TIMP3 in Kawasaki disease. Mol Cell Biochem 2021; 476:4245-4263. [PMID: 34351574 DOI: 10.1007/s11010-021-04238-7] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/28/2021] [Indexed: 11/29/2022]
Abstract
Kawasaki disease (KD) causes cardiovascular system injury in children. However, the pathogenic mechanisms of KD have not been well defined. Recently, strong correlation between aberrant microRNAs and KD nosogenesis has been revealed. A role of microRNA-197-3p (miR-197-3p) in the pathogenesis of KD is identified in the present study. Cell proliferation assay showed human coronary artery endothelial cells (HCAECs) were suppressed by serum from KD patients, which was correlated with high levels of miR-197-3p in both KD serum and HCAECs cultured with KD serum. The inhibition of HCAECs by miR-197-3p was confirmed by cells expressing miR-197-3p mimic and miR-197-3p inhibitor. Comparative proteomics analysis and Ingenuity Pathway Analysis (IPA) revealed TIMP3 as a potential target of miR-197-3p, which was demonstrated by western blot and dual-luciferase reporter assays. Subsequently, by detecting the endothelium damage markers THBS1, VWF, and HSPG2, the role of miR-197-3p/TIMP3 in KD-induced damage to HCAECs was confirmed, which was further validated by a KD mouse model in vivo. The expressions of miR-197-3p and its target, TIMP3, are dramatically variational in KD serum and HCAECs cultured with KD serum. Increased miR-197-3p induces HCAECs abnormal by restraining TIMP3 expression directly. Hence, dysregulation of miR-197-3p/TIMP3 expression in HCAECs may be an important mechanism in cardiovascular endothelium injury in KD patients, which offers a feasible therapeutic target for KD treatment.
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Affiliation(s)
- Chaowu Liu
- Institute of Mass Spectrometer and Atmospheric Environment, Jinan University, Guangzhou, 510632, China
- Guangdong Institute of Microbiology, Guangdong Academy of Sciences, State Key Laboratory of Applied Microbiology Southern China, Guangzhou, 510070, Guangdong, China
| | - Deguang Yang
- Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, Guangdong, China
| | - Hong Wang
- Guangdong Province Engineering Research Center for Antibody Drug and Immunoassay, Colleges of Life Science and Technology, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Shengwei Hu
- MOE Key Laboratory of Tumor Molecular Biology, Clinical Translational Center for Targeted Drug, Department of Pharmacology, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Xiaofei Xie
- Department of Pediatric Cardiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, Guangdong, China
| | - Li Zhang
- Department of Pediatric Cardiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, Guangdong, China
| | - Hongling Jia
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China.
| | - Qi Qi
- MOE Key Laboratory of Tumor Molecular Biology, Clinical Translational Center for Targeted Drug, Department of Pharmacology, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China.
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10
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Kassiteridi C, Cole JE, Griseri T, Falck-Hansen M, Goddard ME, Seneviratne AN, Green PA, Park I, Shami AG, Pattarabanjird T, Upadhye A, Taylor AM, Handa A, Channon KM, Lutgens E, McNamara CA, Williams RO, Monaco C. CD200 Limits Monopoiesis and Monocyte Recruitment in Atherosclerosis. Circ Res 2021; 129:280-295. [PMID: 33975450 PMCID: PMC8260471 DOI: 10.1161/circresaha.119.316062] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 05/06/2021] [Accepted: 05/10/2021] [Indexed: 12/26/2022]
Abstract
[Figure: see text].
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Animals
- Antigens, CD/genetics
- Antigens, CD/metabolism
- Aorta/immunology
- Aorta/metabolism
- Aorta/pathology
- Aortic Diseases/genetics
- Aortic Diseases/immunology
- Aortic Diseases/metabolism
- Aortic Diseases/pathology
- Atherosclerosis/genetics
- Atherosclerosis/immunology
- Atherosclerosis/metabolism
- Atherosclerosis/pathology
- Cells, Cultured
- Chemotaxis, Leukocyte
- Coronary Artery Disease/diagnostic imaging
- Coronary Artery Disease/immunology
- Coronary Artery Disease/metabolism
- Disease Models, Animal
- Female
- Humans
- Leukopoiesis
- Macrophages/immunology
- Macrophages/metabolism
- Male
- Membrane Glycoproteins/metabolism
- Mice, Inbred C57BL
- Mice, Knockout, ApoE
- Middle Aged
- Monocytes/immunology
- Monocytes/metabolism
- Orexin Receptors/metabolism
- Phosphorylation
- Plaque, Atherosclerotic
- STAT1 Transcription Factor/metabolism
- Signal Transduction
- Mice
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Affiliation(s)
- Christina Kassiteridi
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (C.K., J.E.C., T.G., M.F.-H., M.E.G., A.N.S., P.A.G., I.P., R.O.W., C.A.M.), University of Oxford, UK
| | - Jennifer E. Cole
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (C.K., J.E.C., T.G., M.F.-H., M.E.G., A.N.S., P.A.G., I.P., R.O.W., C.A.M.), University of Oxford, UK
| | - Thibault Griseri
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (C.K., J.E.C., T.G., M.F.-H., M.E.G., A.N.S., P.A.G., I.P., R.O.W., C.A.M.), University of Oxford, UK
| | - Mika Falck-Hansen
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (C.K., J.E.C., T.G., M.F.-H., M.E.G., A.N.S., P.A.G., I.P., R.O.W., C.A.M.), University of Oxford, UK
| | - Michael E. Goddard
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (C.K., J.E.C., T.G., M.F.-H., M.E.G., A.N.S., P.A.G., I.P., R.O.W., C.A.M.), University of Oxford, UK
| | - Anusha N. Seneviratne
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (C.K., J.E.C., T.G., M.F.-H., M.E.G., A.N.S., P.A.G., I.P., R.O.W., C.A.M.), University of Oxford, UK
| | - Patricia A. Green
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (C.K., J.E.C., T.G., M.F.-H., M.E.G., A.N.S., P.A.G., I.P., R.O.W., C.A.M.), University of Oxford, UK
| | - Inhye Park
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (C.K., J.E.C., T.G., M.F.-H., M.E.G., A.N.S., P.A.G., I.P., R.O.W., C.A.M.), University of Oxford, UK
| | - Annelie G. Shami
- Experimental Vascular Biology Division, Department of Medical Biochemistry, Amsterdam UMC, the Netherlands (A.G.S.,)
| | | | - Aditi Upadhye
- Cardiovascular Research Center, University of Virginia (T.P., A.U., A.M.T., C.A.M.)
| | - Angela M. Taylor
- Cardiovascular Research Center, University of Virginia (T.P., A.U., A.M.T., C.A.M.)
| | - Ashok Handa
- Nuffield Department of Surgical Sciences (A.H.), University of Oxford, UK
| | - Keith M. Channon
- Radcliffe Department of Medicine, RDM Cardiovascular Medicine (K.M.C.), University of Oxford, UK
| | - Esther Lutgens
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians Universität, München, Germany & German Center for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Munich, Germany (E.L.)
| | - Coleen A. McNamara
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (C.K., J.E.C., T.G., M.F.-H., M.E.G., A.N.S., P.A.G., I.P., R.O.W., C.A.M.), University of Oxford, UK
- Cardiovascular Research Center, University of Virginia (T.P., A.U., A.M.T., C.A.M.)
| | - Richard O. Williams
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (C.K., J.E.C., T.G., M.F.-H., M.E.G., A.N.S., P.A.G., I.P., R.O.W., C.A.M.), University of Oxford, UK
| | - Claudia Monaco
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (C.K., J.E.C., T.G., M.F.-H., M.E.G., A.N.S., P.A.G., I.P., R.O.W., C.A.M.), University of Oxford, UK
- Nuffield Department of Surgical Sciences (A.H.), University of Oxford, UK
- Radcliffe Department of Medicine, RDM Cardiovascular Medicine (K.M.C.), University of Oxford, UK
- Experimental Vascular Biology Division, Department of Medical Biochemistry, Amsterdam UMC, the Netherlands (A.G.S.,)
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians Universität, München, Germany & German Center for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Munich, Germany (E.L.)
- Cardiovascular Research Center, University of Virginia (T.P., A.U., A.M.T., C.A.M.)
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11
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Kamal SM, Winters JM, Al Othman BA, Kini AT, Beaver HA, Lee AG. Immune-Mediated Optic Neuropathy in Chronically Immunosuppressed Transplant Patients. J Neuroophthalmol 2021; 41:e180-e183. [PMID: 32826713 DOI: 10.1097/wno.0000000000001030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Sarah M Kamal
- McGovern Medical School (SK), Houston, Texas; Texas Tech University Health Sciences Center (JW), El Paso Paul L. Foster School of Medicine, El Paso, Texas; Department of Ophthalmology (BAO, AK, HB, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Department of Ophthalmology (HB, AGL), Weill Cornell Medicine, New York, New York; Department of Ophthalmology (HB, AGL), University of Texas Medical Branch, Galveston, Texas; Departments of Neurology and Neurosurgery (AGL), Weill Cornell Medicine, New York, New York; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; Texas A and M College of Medicine (AGL), Bryan, Texas; and Department of Ophthalmology (AGL), The University of Iowa Hospitals and Clinics, Iowa City, Iowa
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12
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Lee AC, Castaneda G, Li WT, Chen C, Shende N, Chakladar J, Taub PR, Chang EY, Ongkeko WM. COVID-19 Severity Potentially Modulated by Cardiovascular-Disease-Associated Immune Dysregulation. Viruses 2021; 13:1018. [PMID: 34071557 PMCID: PMC8228164 DOI: 10.3390/v13061018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 12/15/2022] Open
Abstract
Patients with underlying cardiovascular conditions are particularly vulnerable to severe COVID-19. In this project, we aimed to characterize similarities in dysregulated immune pathways between COVID-19 patients and patients with cardiomyopathy, venous thromboembolism (VTE), or coronary artery disease (CAD). We hypothesized that these similarly dysregulated pathways may be critical to how cardiovascular diseases (CVDs) exacerbate COVID-19. To evaluate immune dysregulation in different diseases, we used four separate datasets, including RNA-sequencing data from human left ventricular cardiac muscle samples of patients with dilated or ischemic cardiomyopathy and healthy controls; RNA-sequencing data of whole blood samples from patients with single or recurrent event VTE and healthy controls; RNA-sequencing data of human peripheral blood mononuclear cells (PBMCs) from patients with and without obstructive CAD; and RNA-sequencing data of platelets from COVID-19 subjects and healthy controls. We found similar immune dysregulation profiles between patients with CVDs and COVID-19 patients. Interestingly, cardiomyopathy patients display the most similar immune landscape to COVID-19 patients. Additionally, COVID-19 patients experience greater upregulation of cytokine- and inflammasome-related genes than patients with CVDs. In all, patients with CVDs have a significant overlap of cytokine- and inflammasome-related gene expression profiles with that of COVID-19 patients, possibly explaining their greater vulnerability to severe COVID-19.
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Affiliation(s)
- Abby C. Lee
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, UC San Diego School of Medicine, San Diego, CA 92093, USA; (A.C.L.); (G.C.); (W.T.L.); (C.C.); (N.S.); (J.C.)
- Research Service, VA San Diego Healthcare System, San Diego, CA 92161, USA;
| | - Grant Castaneda
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, UC San Diego School of Medicine, San Diego, CA 92093, USA; (A.C.L.); (G.C.); (W.T.L.); (C.C.); (N.S.); (J.C.)
- Research Service, VA San Diego Healthcare System, San Diego, CA 92161, USA;
| | - Wei Tse Li
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, UC San Diego School of Medicine, San Diego, CA 92093, USA; (A.C.L.); (G.C.); (W.T.L.); (C.C.); (N.S.); (J.C.)
- Research Service, VA San Diego Healthcare System, San Diego, CA 92161, USA;
| | - Chengyu Chen
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, UC San Diego School of Medicine, San Diego, CA 92093, USA; (A.C.L.); (G.C.); (W.T.L.); (C.C.); (N.S.); (J.C.)
- Research Service, VA San Diego Healthcare System, San Diego, CA 92161, USA;
| | - Neil Shende
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, UC San Diego School of Medicine, San Diego, CA 92093, USA; (A.C.L.); (G.C.); (W.T.L.); (C.C.); (N.S.); (J.C.)
- Research Service, VA San Diego Healthcare System, San Diego, CA 92161, USA;
| | - Jaideep Chakladar
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, UC San Diego School of Medicine, San Diego, CA 92093, USA; (A.C.L.); (G.C.); (W.T.L.); (C.C.); (N.S.); (J.C.)
- Research Service, VA San Diego Healthcare System, San Diego, CA 92161, USA;
| | - Pam R. Taub
- Department of Medicine, Division of Cardiovascular Medicine, University of California, San Diego, CA 92093, USA;
| | - Eric Y. Chang
- Research Service, VA San Diego Healthcare System, San Diego, CA 92161, USA;
- Department of Radiology, University of California, San Diego, CA 92093, USA
| | - Weg M. Ongkeko
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, UC San Diego School of Medicine, San Diego, CA 92093, USA; (A.C.L.); (G.C.); (W.T.L.); (C.C.); (N.S.); (J.C.)
- Research Service, VA San Diego Healthcare System, San Diego, CA 92161, USA;
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13
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Gruzdeva OV, Belik EV, Dyleva YA, Borodkina DA, Sinitsky MY, Naumov DY, Bychkova EE, Fanaskova EV, Palicheva EI, Kuzmina AA, Karetnikova VN, Barbarash OL. Expression of adipocytokines in heart fat depots depending on the degree of coronary artery atherosclerosis in patients with coronary artery disease. PLoS One 2021; 16:e0248716. [PMID: 33735200 PMCID: PMC7971506 DOI: 10.1371/journal.pone.0248716] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/03/2021] [Indexed: 12/12/2022] Open
Abstract
In coronary artery disease (CAD) the adipocytokine content in the heart fat depot is altered, but it has not been established whether these changes are associated with the degree of atherosclerotic damage to the coronary artery (CA). Were examined 84 patients with CAD, and according to the degree of atherosclerotic state based on the SYNTAX Score scale, were divided: 39 moderate (≤22 points), 20 severe (23–31 points) and 25 extremely severe (≥32 points). Biopsies of subcutaneous (SAT), epicardial (EAT) and perivascular adipose tissue (PVAT) were obtained during elective coronary artery bypass grafting (CABG). The expression of adipocytokine was determined using real-time PCR. The concentration of the studied adipocytokines in adipocyte culture medium was measured by ELISA. Statistical analysis was performed using logistic regression analysis. In the adipocytes of the cardiac depot of patients with CAD, an increase in the expression and secretion of leptin and IL-6 and a decrease in adiponectin, with a maximum manifestation in severe and extremely severe CA lesions, was observed. EAT adipocytes were characterized by minimal expression of the adiponectin gene maximal gene expression leptin and IL-6 compared to SAT and PVAT adipocytes.
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Affiliation(s)
- Olga V. Gruzdeva
- Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Disease”, Sosnovyi bulvar, Kemerovo, Russian Federation
| | - Ekaterina V. Belik
- Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Disease”, Sosnovyi bulvar, Kemerovo, Russian Federation
- * E-mail:
| | - Yulia A. Dyleva
- Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Disease”, Sosnovyi bulvar, Kemerovo, Russian Federation
| | - Daria A. Borodkina
- Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Disease”, Sosnovyi bulvar, Kemerovo, Russian Federation
| | - Maxim Yu. Sinitsky
- Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Disease”, Sosnovyi bulvar, Kemerovo, Russian Federation
| | - Danil Yu. Naumov
- Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Disease”, Sosnovyi bulvar, Kemerovo, Russian Federation
| | - Evgeniya E. Bychkova
- Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Disease”, Sosnovyi bulvar, Kemerovo, Russian Federation
| | - Elena V. Fanaskova
- Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Disease”, Sosnovyi bulvar, Kemerovo, Russian Federation
| | - Elena I. Palicheva
- Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Disease”, Sosnovyi bulvar, Kemerovo, Russian Federation
| | - Anastasia A. Kuzmina
- Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Disease”, Sosnovyi bulvar, Kemerovo, Russian Federation
| | - Viktoriya N. Karetnikova
- Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Disease”, Sosnovyi bulvar, Kemerovo, Russian Federation
| | - Olga L. Barbarash
- Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Disease”, Sosnovyi bulvar, Kemerovo, Russian Federation
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14
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Hofeld BC, Puppala VK, Tyagi S, Ahn KW, Anger A, Jia S, Salzman NH, Hessner MJ, Widlansky ME. Lactobacillus plantarum 299v probiotic supplementation in men with stable coronary artery disease suppresses systemic inflammation. Sci Rep 2021; 11:3972. [PMID: 33597583 PMCID: PMC7889883 DOI: 10.1038/s41598-021-83252-7] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/25/2021] [Indexed: 12/15/2022] Open
Abstract
Recent trials demonstrate that systemic anti-inflammatory therapy reduces cardiovascular events in coronary artery disease (CAD) patients. We recently demonstrated Lactobacillus plantarum 299v (Lp299v) supplementation improved vascular endothelial function in men with stable CAD. Whether this favorable effect is in part due to anti-inflammatory action remains unknown. Testing this hypothesis, we exposed plasma obtained before and after Lp299v supplementation from these subjects to a healthy donor's PBMCs and measured differences in the PBMC transciptome, performed gene ontological analyses, and compared Lp299v-induced transcriptome changes with changes in vascular function. Daily alcohol users (DAUs) (n = 4) had a significantly different response to Lp299v and were separated from the main analyses. Non-DAUs- (n = 15) showed improved brachial flow-mediated dilation (FMD) and reduced circulating IL-8, IL-12, and leptin. 997 genes were significantly changed. I.I.com decreased (1.01 ± 0.74 vs. 0.22 ± 0.51; P < 0.0001), indicating strong anti-inflammatory effects. Pathway analyses revealed downregulation of IL-1β, interferon-stimulated pathways, and toll-like receptor signaling, and an increase in regulator T-cell (Treg) activity. Reductions in GBP1, JAK2, and TRAIL expression correlated with improved FMD. In non-DAU men with stable CAD, post-Lp299v supplementation plasma induced anti-inflammatory transcriptome changes in human PBMCs that could benefit CAD patients. Future studies should delineate changes in circulating metabolites responsible for these effects.
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Affiliation(s)
- Benjamin C Hofeld
- Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Venkata K Puppala
- Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sudhi Tyagi
- Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kwang Woo Ahn
- Department of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Amberly Anger
- Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Shuang Jia
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Nita H Salzman
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Martin J Hessner
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Michael E Widlansky
- Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
- Division of Cardiovascular Medicine, Professor of Medicine and Pharmacology, Medical College of Wisconsin, Hub for Collaborative Medicine, 5th Floor A5743, 8701 W. Watertown Plank Road, Milwaukee, WI, 53226, USA.
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15
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Silvis MJM, Demkes EJ, Fiolet ATL, Dekker M, Bosch L, van Hout GPJ, Timmers L, de Kleijn DPV. Immunomodulation of the NLRP3 Inflammasome in Atherosclerosis, Coronary Artery Disease, and Acute Myocardial Infarction. J Cardiovasc Transl Res 2021; 14:23-34. [PMID: 32648087 PMCID: PMC7892681 DOI: 10.1007/s12265-020-10049-w] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [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: 02/28/2020] [Accepted: 06/09/2020] [Indexed: 02/06/2023]
Abstract
Cardiovascular disease (CVD) remains the leading cause of mortality and morbidity worldwide. Atherosclerosis is responsible for the majority of cardiovascular disorders with inflammation as one of its driving processes. The nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3) inflammasome, responsible for the release of the pro-inflammatory cytokines, interleukin-1β (IL-1β), and interleukin-18 (IL-18), has been studied extensively and showed to play a pivotal role in the progression of atherosclerosis, coronary artery disease (CAD), and myocardial ischemia reperfusion (I/R) injury. Both the NLRP3 inflammasome and its downstream cytokines, IL-1ß and IL-18, could therefore be promising targets in cardiovascular disease. This review summarizes the role of the NLRP3 inflammasome in atherosclerosis, CAD, and myocardial I/R injury. Furthermore, the current therapeutic approaches targeting the NLRP3 inflammasome and its downstream signaling cascade in atherosclerosis, CAD, and myocardial I/R injury are discussed.
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Affiliation(s)
- Max J M Silvis
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3508, GA, Utrecht, The Netherlands.
| | - Evelyne J Demkes
- Department of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Aernoud T L Fiolet
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3508, GA, Utrecht, The Netherlands
| | - Mirthe Dekker
- Department of Vascular Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Cardiology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Lena Bosch
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3508, GA, Utrecht, The Netherlands
- Department of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gerardus P J van Hout
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3508, GA, Utrecht, The Netherlands
- Department of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Leo Timmers
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
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16
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Zaric BL, Radovanovic JN, Gluvic Z, Stewart AJ, Essack M, Motwalli O, Gojobori T, Isenovic ER. Atherosclerosis Linked to Aberrant Amino Acid Metabolism and Immunosuppressive Amino Acid Catabolizing Enzymes. Front Immunol 2020; 11:551758. [PMID: 33117340 PMCID: PMC7549398 DOI: 10.3389/fimmu.2020.551758] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [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: 04/14/2020] [Accepted: 08/25/2020] [Indexed: 02/05/2023] Open
Abstract
Cardiovascular disease is the leading global health concern and responsible for more deaths worldwide than any other type of disorder. Atherosclerosis is a chronic inflammatory disease in the arterial wall, which underpins several types of cardiovascular disease. It has emerged that a strong relationship exists between alterations in amino acid (AA) metabolism and the development of atherosclerosis. Recent studies have reported positive correlations between levels of branched-chain amino acids (BCAAs) such as leucine, valine, and isoleucine in plasma and the occurrence of metabolic disturbances. Elevated serum levels of BCAAs indicate a high cardiometabolic risk. Thus, BCAAs may also impact atherosclerosis prevention and offer a novel therapeutic strategy for specific individuals at risk of coronary events. The metabolism of AAs, such as L-arginine, homoarginine, and L-tryptophan, is recognized as a critical regulator of vascular homeostasis. Dietary intake of homoarginine, taurine, and glycine can improve atherosclerosis by endothelium remodeling. Available data also suggest that the regulation of AA metabolism by indoleamine 2,3-dioxygenase (IDO) and arginases 1 and 2 are mediated through various immunological signals and that immunosuppressive AA metabolizing enzymes are promising therapeutic targets against atherosclerosis. Further clinical studies and basic studies that make use of animal models are required. Here we review recent data examining links between AA metabolism and the development of atherosclerosis.
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Affiliation(s)
- Bozidarka L. Zaric
- Department of Radiobiology and Molecular Genetics, “VINČA” Institute of Nuclear Sciences - National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Jelena N. Radovanovic
- Department of Radiobiology and Molecular Genetics, “VINČA” Institute of Nuclear Sciences - National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Zoran Gluvic
- Department of Endocrinology and Diabetes, Faculty of Medicine, University Clinical-Hospital Centre Zemun-Belgrade, University of Belgrade, Belgrade, Serbia
| | - Alan J. Stewart
- School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Magbubah Essack
- Computer, Electrical and Mathematical Sciences and Engineering Division (CEMSE), Computational Bioscience Research Center, Computer (CBRC), King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
| | - Olaa Motwalli
- College of Computing and Informatics, Saudi Electronic University (SEU), Medina, Saudi Arabia
| | - Takashi Gojobori
- Computer, Electrical and Mathematical Sciences and Engineering Division (CEMSE), Computational Bioscience Research Center, Computer (CBRC), King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
- Biological and Environmental Sciences and Engineering Division (BESE), King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
| | - Esma R. Isenovic
- Department of Radiobiology and Molecular Genetics, “VINČA” Institute of Nuclear Sciences - National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
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17
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Fiolet ATL, Silvis MJM, Opstal TSJ, Bax WA, van der Horst FAL, Mosterd A, de Kleijn D, Cornel JH. Short-term effect of low-dose colchicine on inflammatory biomarkers, lipids, blood count and renal function in chronic coronary artery disease and elevated high-sensitivity C-reactive protein. PLoS One 2020; 15:e0237665. [PMID: 32866166 PMCID: PMC7458326 DOI: 10.1371/journal.pone.0237665] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 07/29/2020] [Indexed: 11/19/2022] Open
Abstract
Aims Inflammation plays a pivotal role in atherothrombosis. Colchicine is an anti-inflammatory drug that may attenuate this process. Cardiovascular protective effects of anti-inflammatory drugs, however, seem to be limited to patients with a biochemical response. We therefore investigated whether short-term exposure to colchicine reduced inflammatory markers and whether additional laboratory changes occur in patients with chronic coronary artery disease. Methods & results In 138 consecutive patients with chronic coronary artery disease and a high sensitivity C-reactive Protein (hs-CRP) ≥ 2 mg/L, inflammatory markers, lipids, haematologic parameters and renal function were measured at baseline and after 30 days exposure to colchicine 0.5mg once daily. Hs-CRP decreased from baseline 4.40 mg/L (interquartile range [IQR] 2.83–6.99 mg/L) to 2.33 mg/L (IQR 1.41–4.17, median of the differences -1.66 mg/L, 95% confidence interval [CI] -2.17 – -1.22 mg/L, p-value <0.01), corresponding to a median change from baseline of -40%. Interleukin-6 decreased from 2.51 ng/L (IQR 1.59–4.32 ng/L) to 2.22 ng/L (median of the differences -0.36 ng/L, 95%CI -0.70 – -0.01 ng/L, p-value 0.04), corresponding to a median change from baseline of -16%. No clinically relevant changes in lipid fractions were observed. Both leukocyte and thrombocyte count decreased (median change from baseline -7% and -4% respectively). Estimated glomerular filtration rate decreased with a mean change from baseline of -2%. Conclusion In patients with chronic coronary artery disease and elevated hs-CRP, one-month exposure to colchicine 0.5 mg once daily was associated with a reduction of inflammatory markers. A small effect was seen on white blood cell count and platelet count, as well as a small decrease in estimated glomerular filtration rate.
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Affiliation(s)
- Aernoud T. L. Fiolet
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
- Dutch Network for Cardiovascular Research, Utrecht, The Netherlands
- The Netherlands Heart Institute, Utrecht, The Netherlands
| | - Max J. M. Silvis
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Willem A. Bax
- Department of Internal Medicine, Northwest Clinics, Alkmaar, The Netherlands
| | | | - Arend Mosterd
- Dutch Network for Cardiovascular Research, Utrecht, The Netherlands
- Department of Cardiology, Meander Medisch Centrum, Amersfoort, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Dominique de Kleijn
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jan H. Cornel
- Dutch Network for Cardiovascular Research, Utrecht, The Netherlands
- Department of Cardiology, Northwest Clinics, Alkmaar, The Netherlands
- Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
- * E-mail:
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18
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Hoffmann J, Puntmann VO, Fišer K, Rasper T, Berkowitsch A, Carerj ML, Nagel E, Dimmeler S, Zeiher AM. Circulating Th17 and Th22 Cells Are Associated With CMR Imaging Biosignatures of Diffuse Myocardial Interstitial Remodeling in Chronic Coronary Artery Disease. Circ Res 2020; 127:699-701. [PMID: 32576092 PMCID: PMC7418928 DOI: 10.1161/circresaha.120.316619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Jedrzej Hoffmann
- From the Departments of Medicine and Cardiology (J.H., V.O.P., A.B., E.N., A.M.Z.), Goethe University, Frankfurt, Germany
- Institute for Experimental and Translational Cardiovascular Imaging (J.H., V.O.P., M.L.C., E.N., S.D.), Goethe University, Frankfurt, Germany
- German Center for Cardiovascular Research DZHK, Berlin, Germany, partner site Rhine-Main (J.H., V.O.P., E.N., S.D., A.M.Z.)
| | - Valentina O. Puntmann
- From the Departments of Medicine and Cardiology (J.H., V.O.P., A.B., E.N., A.M.Z.), Goethe University, Frankfurt, Germany
- Institute for Experimental and Translational Cardiovascular Imaging (J.H., V.O.P., M.L.C., E.N., S.D.), Goethe University, Frankfurt, Germany
- German Center for Cardiovascular Research DZHK, Berlin, Germany, partner site Rhine-Main (J.H., V.O.P., E.N., S.D., A.M.Z.)
| | - Karel Fišer
- Department of Pediatric Haematology and Oncology, CLIP—Childhood Leukemia Investigation Prague, Charles University, Czech Republic (K.F.)
| | - Tina Rasper
- Institute of Cardiovascular Regeneration, Center of Molecular Medicine (T.R., S.D.), Goethe University, Frankfurt, Germany
| | - Alexander Berkowitsch
- From the Departments of Medicine and Cardiology (J.H., V.O.P., A.B., E.N., A.M.Z.), Goethe University, Frankfurt, Germany
| | - Maria Ludovica Carerj
- Institute for Experimental and Translational Cardiovascular Imaging (J.H., V.O.P., M.L.C., E.N., S.D.), Goethe University, Frankfurt, Germany
| | - Eike Nagel
- From the Departments of Medicine and Cardiology (J.H., V.O.P., A.B., E.N., A.M.Z.), Goethe University, Frankfurt, Germany
- Institute for Experimental and Translational Cardiovascular Imaging (J.H., V.O.P., M.L.C., E.N., S.D.), Goethe University, Frankfurt, Germany
- German Center for Cardiovascular Research DZHK, Berlin, Germany, partner site Rhine-Main (J.H., V.O.P., E.N., S.D., A.M.Z.)
| | - Stefanie Dimmeler
- Institute for Experimental and Translational Cardiovascular Imaging (J.H., V.O.P., M.L.C., E.N., S.D.), Goethe University, Frankfurt, Germany
- Institute of Cardiovascular Regeneration, Center of Molecular Medicine (T.R., S.D.), Goethe University, Frankfurt, Germany
- German Center for Cardiovascular Research DZHK, Berlin, Germany, partner site Rhine-Main (J.H., V.O.P., E.N., S.D., A.M.Z.)
| | - Andreas M. Zeiher
- From the Departments of Medicine and Cardiology (J.H., V.O.P., A.B., E.N., A.M.Z.), Goethe University, Frankfurt, Germany
- German Center for Cardiovascular Research DZHK, Berlin, Germany, partner site Rhine-Main (J.H., V.O.P., E.N., S.D., A.M.Z.)
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19
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Zhu Z, Hasegawa K, Ma B, Fujiogi M, Camargo CA, Liang L. Association of asthma and its genetic predisposition with the risk of severe COVID-19. J Allergy Clin Immunol 2020; 146:327-329.e4. [PMID: 32522462 PMCID: PMC7423602 DOI: 10.1016/j.jaci.2020.06.001] [Citation(s) in RCA: 147] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 05/29/2020] [Accepted: 06/03/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Zhaozhong Zhu
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass; Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Kohei Hasegawa
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Baoshan Ma
- College of Information Science and Technology, Dalian Maritime University, Dalian, Liaoning, China
| | - Michimasa Fujiogi
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Liming Liang
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass.
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20
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Qi L, Zhang J, Wu K, Shi S, Ji Q, Miao H, Que B. IL-19 as a Biomarker for the Severity of Acute Myocardial Infarction. Arch Med Res 2020; 51:160-166. [PMID: 32111500 DOI: 10.1016/j.arcmed.2020.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/06/2019] [Accepted: 01/20/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Interleukin-19 (IL-19) has been shown to be involved in coronary artery diseases and atherosclerosis, while its expression in myocardial infarction is poorly understood. In this study, the dynamic increase in circulating IL-19 in acute ST-segment elevation myocardial infarction (STEMI) patients was detected. METHOD Both plasma IL-19 levels and IL-19 mRNA expression in peripheral blood mononuclear cells (PBMCs) from STEMI patients and chest pain syndrome (CPS) patients were detected at different time points, including 1 d, 3 d, 7 d and 14 d after treatment and on admission. RESULTS Compared with the CPS patients, IL-19 levels and IL-19 gene expression were significantly increased in STEMI patients and peaked at 1 d. From 1-14 d, refocusing treatment, including emergency percutaneous coronary intervention (PCI) and thrombolysis, markedly reduced IL-19 expression and promoted its recovery; of the treatments, the effect of emergency PCI was most significant. In addition, similar trends were also observed with cTnI, NT-proBNP and C-reactive protein (CRP) levels. Furthermore, correlation analysis showed that IL-19 levels were positively correlated with cTnI, NT-proBNP, CRP levels and left ventricular ejection fraction (LVEF) in STEMI patients. CONCLUSIONS IL-19 is correlated with the severity of acute myocardial infarction, which may be a new idea for the clinical treatment of myocardial infarction.
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Affiliation(s)
- Liping Qi
- Department of Cardiology, The Second Clinical Center, Chinese PLA General Hospital, Beijing, China
| | - Jianwei Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Kui Wu
- Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, and Beijing Lab for Cardiovascular Precision Medicine, Beijing, China
| | - Shutian Shi
- Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, and Beijing Lab for Cardiovascular Precision Medicine, Beijing, China
| | - Qingwei Ji
- Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, and Beijing Lab for Cardiovascular Precision Medicine, Beijing, China
| | - Huangtai Miao
- Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, and Beijing Lab for Cardiovascular Precision Medicine, Beijing, China
| | - Bin Que
- Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, and Beijing Lab for Cardiovascular Precision Medicine, Beijing, China.
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21
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Abstract
Macrophages play a central role in the development of atherosclerotic cardiovascular disease (ASCVD), which encompasses coronary artery disease, peripheral artery disease, cerebrovascular disease, and aortic atherosclerosis. In each vascular bed, macrophages contribute to the maintenance of the local inflammatory response, propagate plaque development, and promote thrombosis. These central roles, coupled with their plasticity, makes macrophages attractive therapeutic targets in stemming the development of and stabilizing existing atherosclerosis. In the context of ASCVD, classically activated M1 macrophages initiate and sustain inflammation, and alternatively activated M2 macrophages resolve inflammation. However, this classification is now considered an oversimplification, and a greater understanding of plaque macrophage physiology in ASCVD is required to aid in the development of therapeutics to promote ASCVD regression. Reviewed herein are the macrophage phenotypes and molecular regulators characteristic of ASCVD regression, and the current murine models of ASCVD regression.
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Affiliation(s)
- Tessa J. Barrett
- From the Division of Cardiology, Department of Medicine, New York University
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22
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Ichimata S, Hata Y, Nishida N. An autopsy case of sudden unexpected death with loxoprofen sodium-induced allergic eosinophilic coronary periarteritis. Cardiovasc Pathol 2019; 44:107154. [PMID: 31760242 DOI: 10.1016/j.carpath.2019.107154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/26/2019] [Accepted: 09/16/2019] [Indexed: 11/18/2022] Open
Abstract
Although the cause of eosinophilic coronary periarteritis (ECPA) remains unclear, an allergic background is present in fewer patients than expected. A 50-year-old man with no history of allergy or symptoms suggestive of cardiac or respiratory disorders suddenly died shortly after oral administration of loxoprofen sodium. Autopsy showed eosinophilic coronary periarteritis in three main branches of the coronary arteries, characterized by eosinophil-predominant inflammation without fibrinoid necrosis or granulomatous change in the adventitia and its surroundings of the three main branches of the coronary arteries, in addition to the localized sign of bronchial asthma in the lung. Immunohistochemical examination showed that many mast cells positive for human mast cell tryptase were evident in the perivascular tissue containing peripheral nerve trunks. Whereas the blood concentration of loxoprofen sodium was within the therapeutic range, significant elevation of the serum histamine and tryptase levels was found. The present case suggests that eosinophilic coronary periarteritis may be caused by a type I allergic reaction in some patients and that loxoprofen sodium can trigger a life-threatening type I allergic reaction, including eosinophilic coronary periarteritis, leading to sudden unexpected death.
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Affiliation(s)
- Shojiro Ichimata
- Department of Legal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan
| | - Yukiko Hata
- Department of Legal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan
| | - Naoki Nishida
- Department of Legal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan.
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23
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Pierzynová A, Šrámek J, Cinkajzlová A, Kratochvílová H, Lindner J, Haluzík M, Kučera T. The number and phenotype of myocardial and adipose tissue CD68+ cells is associated with cardiovascular and metabolic disease in heart surgery patients. Nutr Metab Cardiovasc Dis 2019; 29:946-955. [PMID: 31307852 DOI: 10.1016/j.numecd.2019.05.063] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 12/13/2018] [Revised: 04/26/2019] [Accepted: 05/17/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS CD68+ cells are a potent source of inflammatory cytokines in adipose tissue and myocardium. The development of low-grade inflammation in adipose tissue is implicated in the pathogenesis of obesity-associated disorders including type 2 diabetes mellitus (T2DM) and cardiovascular disease. The main aim of the study was to characterize and quantify myocardial and adipose tissue CD68+ cells and adipose tissue crown-like structures (CLS) in patients with obesity, coronary artery disease (CAD) and T2DM. METHODS AND RESULTS Samples were obtained from the right atrium, epicardial (EAT) and subcutaneous adipose tissue (SAT) during elective heart surgery (non-obese, n = 34 patients; obese, n = 24 patients). Immunohistochemistry was used to visualize CD68+ cells. M1-polarized macrophages were visualized by immunohistochemical detection of CD11c. The proportion of CD68+ cells was higher in EAT than in SAT (43.4 ± 25.0 versus 32.5 ± 23.1 cells per 1 mm2; p = 0.015). Myocardial CD68+ cells were more abundant in obese patients (45.6 ± 24.5 versus 27.7 ± 14.8 cells per 1 mm2; p = 0.045). In SAT, CD68+ cells were more frequent in CAD patients (37.3 ± 23.0 versus 23.1 ± 20.9 cells per 1 mm2; p = 0.012). Patients having CLS in their SAT had higher average BMI (34.1 ± 6.4 versus 29.0 ± 4.5; p = 0.024). CONCLUSIONS Regional-based increases in the frequency of CD68+ cells and changes of their phenotype in CLS were detected in obese patients and CAD patients. Therapeutic modulation of adipose tissue inflammation may represent a target for treatment of obesity.
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Affiliation(s)
- Aneta Pierzynová
- Institute of Histology and Embryology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jaromír Šrámek
- Institute of Histology and Embryology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Anna Cinkajzlová
- Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Department of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Helena Kratochvílová
- Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Department of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Jaroslav Lindner
- 2nd Department of Surgery - Department of Cardiovascular Surgery, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Martin Haluzík
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Department of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Tomáš Kučera
- Institute of Histology and Embryology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
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24
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Newman JL, Stone JR. Immune checkpoint inhibition alters the inflammatory cell composition of human coronary artery atherosclerosis. Cardiovasc Pathol 2019; 43:107148. [PMID: 31518915 DOI: 10.1016/j.carpath.2019.107148] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [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: 06/19/2019] [Revised: 07/19/2019] [Accepted: 08/09/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibition (ICI) has emerged as a promising new approach to treat malignancy. Such therapies can result in autoimmune-related complications such as myocarditis and hepatitis. The impact of ICI on sites of preexisting chronic inflammation has been less clear. Atherosclerosis is a chronic vascular disease with a significant inflammatory component. METHODS To determine the effect of ICI on the inflammatory infiltrate in coronary artery atherosclerotic plaques, 11 patients who had recently been treated with ICI and subsequently underwent autopsy were matched with 11 cancer patients who had not received ICI treatment. The amount of CD3+ T-lymphocytes, CD8+ cytotoxic T-lymphocytes, and CD68+ macrophages and the ratios of the various cell types in the coronary artery atherosclerotic plaques were compared. RESULTS There was no significant difference in the absolute numbers of CD3+, CD8+, or CD68+ cells in the atherosclerotic plaques. In the plaques of the ICI-treated patients, there was a significant increase in the ratio of CD3+ cells to CD68+ cells (CD3/CD68) (P=.002) and a trend towards an increased CD8/CD68 ratio. The increased CD3/CD68 ratio in the ICI-treated patients resulted in 6 of the 11 patients having lymphocyte-predominate inflammation in contrast to the macrophage-predominate inflammation typically found in atherosclerotic plaques. CONCLUSIONS These findings indicate that ICI alters the inflammatory composition of human atherosclerotic plaque and, thus, may influence plaque progression and/or clinical coronary events. SUMMARY In cancer patients, treatment with immune checkpoint inhibition is associated with an altered inflammatory cell composition in coronary artery atherosclerotic plaques with an increased ratio of CD3+ T cells to CD68+ macrophages. Thus, immune checkpoint inhibition may influence plaque progression and/or clinical coronary events.
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Affiliation(s)
- Justine L Newman
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - James R Stone
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
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25
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Abstract
Cardiac allograft vasculopathy remains a major limiting factor in the long-term survival of the heart transplant recipient. Our understanding of its pathogenesis is continuously evolving as advances in imaging modalities have allowed a direct window into the natural history of the disease. Innovation in diagnostic modalities has spurred the proliferation of prognostic tools and biomarkers. And in parallel, pharmacological advances have emerged that have helped ameliorate the disease's progressive course.
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Affiliation(s)
- Andriana P Nikolova
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Jon A Kobashigawa
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
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Hoffmann U, Lu MT, Olalere D, Adami EC, Osborne MT, Ivanov A, Aluru JS, Lee S, Arifovic N, Overton ET, Fichtenbaum CJ, Aberg JA, Alston-Smith B, Klingman KL, Waclawiw M, Burdo TH, Williams KC, Zanni MV, Desvigne-Nickens P, Cooper-Arnold K, Fitch KV, Ribaudo H, Douglas PS, Grinspoon SK. Rationale and design of the Mechanistic Substudy of the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE): Effects of pitavastatin on coronary artery disease and inflammatory biomarkers. Am Heart J 2019; 212:1-12. [PMID: 30928823 PMCID: PMC6596304 DOI: 10.1016/j.ahj.2019.02.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 02/23/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND People with HIV (PWH) have increased cardiovascular events, inflammation, and high-risk coronary atherosclerosis. Statin therapy has been shown to lower the risk of cardiovascular disease (CVD) in the general population, but whether this results from reductions in coronary atherosclerosis and is mediated by decreased inflammation remains unknown. METHODS REPRIEVE is a randomized, placebo-controlled trial of pitavastatin calcium (4 mg/day) vs. placebo enrolling at least 7500 PWH between 40-75 years, on antiretroviral therapy (ART), with low to moderate traditional CVD risk. The Mechanistic Substudy of REPRIEVE (A5333s) is co-enrolling 800 participants from 31 US sites. These participants undergo serial contrast enhanced coronary computed tomography angiography (CCTA) and measurements of biomarkers of inflammation and immune activation at baseline and after 2 years of follow-up. The primary objectives are to determine the effects of pitavastatin on noncalcified coronary atherosclerotic plaque (NCP) volume, low attenuation plaque, and positive remodeling and on changes in immune activation and inflammation and to assess relationships between the two. Changes in CAD will be assessed in a standardized fashion by a core lab with expert readers blinded to time points and participant information; immune activation and inflammation assessment is also performed centrally. RESULTS To date the Mechanistic Substudy has completed planned enrollment, with 805 participants. CONCLUSION This study represents the first large, randomized, CCTA-based assessment of the effects of a primary prevention strategy for CVD on high-risk CAD, immune activation and inflammation among PWH. The study will assess pitavastatin's effects on coronary plaque, and the interrelationship of these changes with biomarkers of immune activation and inflammation in PWH to determine mechanisms of CVD prevention and improved outcomes in this population.
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Affiliation(s)
- Udo Hoffmann
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA.
| | - Michael T Lu
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Devvora Olalere
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Elizabeth C Adami
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Michael T Osborne
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Alex Ivanov
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - John Sukumar Aluru
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Saeyun Lee
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Nadja Arifovic
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Edgar Turner Overton
- Division of Infectious Diseases, University of Alabama at Birmingham School of Medicine, Birmingham, AL
| | - Carl J Fichtenbaum
- Division of Infectious Diseases, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Judith A Aberg
- Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | - Myron Waclawiw
- National Institutes of Health/National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Tricia H Burdo
- Department of Neuroscience, Temple University School of Medicine, Philadelphia, PA
| | | | - Markella V Zanni
- MGH Program in Nutritional Metabolism and Harvard Medical School, Boston, MA
| | | | | | - Kathleen V Fitch
- MGH Program in Nutritional Metabolism and Harvard Medical School, Boston, MA
| | - Heather Ribaudo
- Center for Biostatistics in AIDS Research, Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA
| | - Pamela S Douglas
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
| | - Steven K Grinspoon
- MGH Program in Nutritional Metabolism and Harvard Medical School, Boston, MA
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Abstract
BACKGROUND Toll-like receptor 4 (TLR4) plays an important role in the formation of coronary atherosclerotic plaque and the pathogenesis of coronary artery disease (CAD). OBJECTIVES The aim of the study was to conduct a meta-analysis assessing the relationship between 2 common genetic variants in the TLR4 gene (rs4986790 and rs4986791) and susceptibility to CAD. MATERIAL AND METHODS A systematic search of Web of Science, Embase, Scopus, PubMed, and Wanfang Med Online was undertaken. Case-control studies assessing the association of rs4986790 and rs4986791 with CAD risk were included. The odds ratio (OR) and 95% confidence interval (CI) were used as the metric of choice for the evaluation of risk. RESULTS The literature search generated 427 studies, of which 14 met the inclusion criteria, for a total of 13,927 participants. Our meta-analysis revealed a significant association between rs4986791 and CAD risk in Asians using the dominant model (CT + TT vs CC: OR = 0.35, 95% CI = 0.21-0.56, p < 0.001), heterozygote contrast (CT vs CC: OR = 0.32, 95% CI = 0.19-0.57, p < 0.001) and allele contrast (T vs C: OR = 0.38, 95% CI = 0.25- 0.58, p < 0.001). No significant association between rs4986791 and CAD was observed among Caucasians. For rs4986790, the results provided no evidence of an association with CAD risk. CONCLUSIONS Our analysis suggests that rs4986791 is negatively associated with CAD risk in Asians but not in Caucasians. No association between rs4986790 and CAD risk was found.
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Affiliation(s)
- Jianlong Sheng
- Department of Cardiology, Anhui Provincial Hospital of Anhui Medical University, Hefei, China
- Department of Cardiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jian Xu
- Department of Cardiology, Anhui Provincial Hospital of Anhui Medical University, Hefei, China
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Ma H, Wang Y, Xue Y, Huang D, Kong Y, Zhao X, Zhang M. The effect of Xinkeshu tablets on depression and anxiety symptoms in patients with coronary artery disease: Results from a double-blind, randomized, placebo-controlled study. Biomed Pharmacother 2019; 112:108639. [PMID: 30784924 DOI: 10.1016/j.biopha.2019.108639] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 12/15/2018] [Revised: 01/25/2019] [Accepted: 01/28/2019] [Indexed: 02/05/2023] Open
Abstract
A large proportion of patients with coronary artery disease (CAD) suffer from depression or anxiety symptoms and this is associated with increased mortality [1]. This double-blinded, randomized, placebo-controlled, clinical trial (ChiCTR-IPR-17010940) aimed to explore whether Xinkeshu tablets can reduce anxiety or depressive symptoms in CAD patients and how this is related to the concentration of plasma cytokines. Sixty patients with CAD anda Hospital Anxiety and Depression Scale (HADS-a/HADS-d) score of ≥8 were treated with Xinkeshu tablets or placebo for 12 weeks following percutaneous revascularization. Depressive/anxiety symptoms and the levels of 440 peripheral blood cytokines were evaluated at baseline and after 12 weeks treatment. Results showed significantly lower (P < 0.05) HADS-a/HADS-d and PHQ-9 scores in CAD patients treated with Xinkeshu tablets than in those who received placebo. These improvements were associated with changes in certain peripheral blood cytokines; most notably trappin-2, adiponectin, interleukin 1β (IL-1β), thrombopoietin, activated leukocyte cell adhesion molecule (ALCAM), neurotrophin-3 (NT-3), and transferrin. A significant correlation between anxiety/depression symptoms and trappin-2, NT-3, transferrin, and ALCAM (p < 0.05) were observed in an independent cohort of patients with CAD. These findings were in-keeping with the anti-depressive effects of Xinkeshu tablets. This trial demonstrates that Xinkeshu tablets can improve anxiety and depression symtoms effectively address in patients with coronary heart disease possibly through increasing the blood ratio of anti-inflammatory:pro-inflammatory cytokines.
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Affiliation(s)
- Huan Ma
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong, China
| | - Yu Wang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong, China; Shantou University Medical College, Shantou, Guangdong, China
| | - YunLian Xue
- Department of Statistics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Daozheng Huang
- Intensive Care Unit of Guangdong Geriatric Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yongjie Kong
- The Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Xujie Zhao
- The Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Minzhou Zhang
- The Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China.
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Morariu M, Hodas R, Benedek T, Benedek I, Opincariu D, Mester A, Chitu M, Kovacs I, Rezus C, Pasaroiu D, Mitra N, Szilágyi SM, Georgescu D, Rezus E. Impact of inflammation-mediated response on pan-coronary plaque vulnerability, myocardial viability and ventricular remodeling in the postinfarction period - the VIABILITY study: Protocol for a non-randomized prospective clinical study. Medicine (Baltimore) 2019; 98:e15194. [PMID: 31027064 PMCID: PMC6831282 DOI: 10.1097/md.0000000000015194] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 03/18/2019] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION While the role of inflammation in acute coronary events is well established, the impact of inflammatory-mediated vulnerability of coronary plaques from the entire coronary tree, on the extension of ventricular remodeling and scaring, has not been clarified yet. MATERIALS AND METHODS The present manuscript describes the procedures of the VIABILITY trial, a descriptive prospective single-center cohort study. The main purpose of this trial is to assess the link between systemic inflammation, pan-coronary plaque vulnerability (referring to the plaque vulnerability within the entire coronary tree), myocardial viability and ventricular remodeling in patients who had suffered a recent ST-segment elevation acute myocardial infarction (STEMI). One hundred patients with STEMI who underwent successful revascularization of the culprit lesion in the first 12 hours after the onset of symptoms will be enrolled in the study. The level of systemic inflammation will be evaluated based on the serum biomarker levels (hs-CRP, matrix metalloproteinases, interleukin-6) in the acute phase of the myocardial infarction (MI) and at 1 month. Pan-coronary plaque vulnerability will be assessed based on serum biomarkers known to be associated with increased plaque vulnerability (V-CAM or I-CAM) and at 1 month after infarction, based on computed tomographic angiography analysis of vulnerability features of all coronary plaques. Myocardial viability and remodeling will be assessed based on 3D speckle tracking echocardiography associated with dobutamine infusion and LGE-CMR associated with post-processing imaging methods. The study population will be categorized in 2 subgroups: subgroup 1 - subjects with STEMI and increased inflammatory response at 7 days after the acute event (hs-CRP ≥ 3 mg/dl), and subgroup 2 - subjects with STEMI and no increased inflammatory response at 7 days (hs-CRP < 3 mg/dl). Study outcomes will consist in the rate of post-infarction heart failure development and the major adverse events (MACE) rate. CONCLUSION VIABILITY is the first prospective study designed to evaluate the influence of infarct-related inflammatory response on several major determinants of post-infarction outcomes, such as coronary plaque vulnerability, myocardial viability, and ventricular remodeling.
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Affiliation(s)
- Mirabela Morariu
- Clinic of Cardiology, University of Medicine, Pharmacy, Sciences and Technology of Targu-Mures
| | - Roxana Hodas
- Clinic of Cardiology, University of Medicine, Pharmacy, Sciences and Technology of Targu-Mures
| | - Theodora Benedek
- Clinic of Cardiology, University of Medicine, Pharmacy, Sciences and Technology of Targu-Mures
| | - Imre Benedek
- Clinic of Cardiology, University of Medicine, Pharmacy, Sciences and Technology of Targu-Mures
| | - Diana Opincariu
- Clinic of Cardiology, University of Medicine, Pharmacy, Sciences and Technology of Targu-Mures
| | - Andras Mester
- Clinic of Cardiology, University of Medicine, Pharmacy, Sciences and Technology of Targu-Mures
- Department of Advanced Research in Multimodality Cardiovascular Imaging, Cardio Med Medical Center, Targu-Mures
| | - Monica Chitu
- Clinic of Cardiology, University of Medicine, Pharmacy, Sciences and Technology of Targu-Mures
| | - Istvan Kovacs
- Clinic of Cardiology, University of Medicine, Pharmacy, Sciences and Technology of Targu-Mures
| | - Ciprian Rezus
- University of Medicine and Pharmacy ‘Gr.T.Popa’, Iasi
| | - Dan Pasaroiu
- Department of Advanced Research in Multimodality Cardiovascular Imaging, Cardio Med Medical Center, Targu-Mures
| | - Noemi Mitra
- Department of Advanced Research in Multimodality Cardiovascular Imaging, Cardio Med Medical Center, Targu-Mures
| | - Sándor M. Szilágyi
- Department of Advanced Research in Multimodality Cardiovascular Imaging, Cardio Med Medical Center, Targu-Mures
- Department of Informatics, Faculty of Science, University of Medicine, Pharmacy
| | - Dan Georgescu
- Department of Internal Medicine, University of Medicine, Pharmacy, Sciences and Technology of Targu-Mures, Romania
| | - Elena Rezus
- University of Medicine and Pharmacy ‘Gr.T.Popa’, Iasi
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Mihailovic PM, Lio WM, Herscovici R, Chyu KY, Yano J, Zhao X, Zhou J, Zhou B, Freeman MR, Yang W, Shah PK, Cercek B, Dimayuga PC. Keratin 8 is a potential self-antigen in the coronary artery disease immunopeptidome: A translational approach. PLoS One 2019; 14:e0213025. [PMID: 30811493 PMCID: PMC6392305 DOI: 10.1371/journal.pone.0213025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 02/13/2019] [Indexed: 12/31/2022] Open
Abstract
Background Inflammation is an important risk factor in atherosclerosis, the underlying cause of coronary artery disease (CAD). Unresolved inflammation may result in maladaptive immune responses and lead to immune reactivity to self-antigens. We hypothesized that inflammation in CAD patients would manifest in immune reactivity to self-antigens detectable in soluble HLA-I/peptide complexes in the plasma. Methods Soluble HLA-I/peptide complexes were immuno-precipitated from plasma of male acute coronary syndrome (ACS) patients or age-matched controls and eluted peptides were subjected to mass spectrometry to generate the immunopeptidome. Self-peptides were ranked according to frequency and signal intensity, then mouse homologs of selected peptides were used to test immunologic recall in spleens of male apoE-/- mice fed either normal chow or high fat diet. The peptide detected with highest frequency in patient plasma samples and provoked T cell responses in mouse studies was selected for use as a self-antigen to stimulate CAD patient peripheral blood mononuclear cells (PBMCs). Results The immunopeptidome profile identified self-peptides unique to the CAD patients. The mouse homologs tested showed immune responses in apoE-/- mice. Keratin 8 was selected for further study in patient PBMCs which elicited T Effector cell responses in CAD patients compared to controls, associated with reduced PD-1 mRNA expression. Conclusion An immunopeptidomic strategy to search for self-antigens potentially involved in CAD identified Keratin 8. Self-reactive immune response to Keratin 8 may be an important factor in the inflammatory response in CAD.
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Affiliation(s)
- Peter M. Mihailovic
- Oppenheimer Atherosclerosis Research Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Wai Man Lio
- Oppenheimer Atherosclerosis Research Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Romana Herscovici
- Oppenheimer Atherosclerosis Research Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Kuang-Yuh Chyu
- Oppenheimer Atherosclerosis Research Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Juliana Yano
- Oppenheimer Atherosclerosis Research Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Xiaoning Zhao
- Oppenheimer Atherosclerosis Research Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Jianchang Zhou
- Oppenheimer Atherosclerosis Research Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Bo Zhou
- Division of Cancer Biology and Therapeutics, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Michael R. Freeman
- Division of Cancer Biology and Therapeutics, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Wei Yang
- Division of Cancer Biology and Therapeutics, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Prediman K. Shah
- Oppenheimer Atherosclerosis Research Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Bojan Cercek
- Oppenheimer Atherosclerosis Research Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Paul C. Dimayuga
- Oppenheimer Atherosclerosis Research Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- * E-mail:
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Yetkin GI, Yucel AA, Tekin İÖ, Yılmaz M, Atalay H, Yetkin E. Dendritic cell activation is blunted in patients with coronary artery disease and diabetes mellitus. J Diabetes Complications 2019; 33:134-139. [PMID: 30522792 DOI: 10.1016/j.jdiacomp.2018.11.004] [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: 06/21/2018] [Revised: 10/16/2018] [Accepted: 11/10/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND It has been shown that functional status of dendritic cells (DCs) in diabetic patients with unstable angina pectoris (UAP) are more mature and activated than diabetic patients without coronary artery disease (CAD) and none diabetic patients with UAP. Accordingly we aimed to assess the activation of DCs in patients with CAD with/and without Diabetes Mellitus (DM) and compare to those in subjects with normal coronary arteries (NCA). MATERIALS AND METHODS Twenty three patients with severe CAD who were scheduled to coronary artery by-pass grafting surgery and 6 patients with angiographycally NCAs were included in the study. Activation of peripheral blood DCs have been analyzed by flow cytometric measures of CD86 activation. RESULTS In patients with CAD and without DM, DC activation significantly increased after stimulation of oxidesized LDL (135 ± 121 vs 248 ± 197 p = 0.024). However this activation didn't significantly increased in patients with CAD and DM (100 ± 20 vs 120 ± 97, p = 0,54). Patients with NCAs and without DM showed marked activation of CD86 after stimulation with ox-LDL. CONCLUSION We have documented that DC activation, upon stimulation of ox-LDL has blunted in patients with CAD compared to patients with NCAs. Moreover this defective activation is more pronounced in those with diabetic patients with CAD.
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Affiliation(s)
| | - Aysegul Atak Yucel
- Gazi University Faculty of Medicine, Department of Immunology, Ankara, Turkey.
| | - İshak Özel Tekin
- Zonguldak Bulent Ecevit University School of Medicine, Department of Immonology, Zonguldak, Turkey
| | - Mustafa Yılmaz
- Cukurova University Faculty of Medicine, Department of Pediatric Allergy and Immunology, Adana, Turkey.
| | - Hakan Atalay
- Middle East Hospital Division of Cardiovascular Surgery, Mersin, Turkey.
| | - Ertan Yetkin
- Yenisehir Hospital Division of Cardiology, Mersin, Turkey.
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Cai G, Huang Z, Yu L, Li L. A preliminary study showing no association between methylation levels of C3 gene promoter and the risk of CAD. Lipids Health Dis 2019; 18:5. [PMID: 30611277 PMCID: PMC6320636 DOI: 10.1186/s12944-018-0949-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 12/17/2018] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE Coronary artery disease (CAD) is a multi-factor disease. Complement component 3 (C3) plays an important role in the development of CAD. The present study investigated the association between DNA methylation status of C3 gene promoter and the risk of CAD. METHODS One hundred CAD patients and 1 hundred age-and gender- matched controls were recruited in current study. Methylation levels in CpG island in C3 promoter were determined by the method of bisulfite amplicon sequencing. RESULTS Methylation levels of four CpG sites in C3 promoter were measured. There were no significant difference in methylation level of each CpG site between CAD patients and controls. Average methylation rate was also calculated. No significant difference in average methylation rate was observed between CAD and control groups. Stratified analyses based on EH, DM and smoking status were carried out, no significant association between C3 promoter methylation levels and the susceptibility of CAD was observed. Furthermore, seven haplotypes were established and no significant difference in haplotypes was observed between CAD and control groups. However, our study showed that C3 DNA methylation levels were positively associated with LDL-C levels. CONCLUSION The present study showed no association between methylation levels of C3 promoter and the risk of CAD. However, the methylation levels might be related to LDL-C levels.
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Affiliation(s)
- Gaojun Cai
- Department of Cardiology, Wujin Hospital affiliated with Jiangsu University, Changzhou, Jiangsu Province, 213017 China
| | - Zhiying Huang
- Department of Pediatrics, No. 2 Hospital of Changzhou, Changzhou, 213001 Jiangsu China
| | - Lei Yu
- Department of Cardiology, Wujin Hospital affiliated with Jiangsu University, Changzhou, Jiangsu Province, 213017 China
| | - Li Li
- Department of Cardiology, Wujin Hospital affiliated with Jiangsu University, Changzhou, Jiangsu Province, 213017 China
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Akosile W, Voisey J, Lawford B, Colquhounc D, Young RM, Mehta D. The inflammasome NLRP12 is associated with both depression and coronary artery disease in Vietnam veterans. Psychiatry Res 2018; 270:775-779. [PMID: 30551324 DOI: 10.1016/j.psychres.2018.10.051] [Citation(s) in RCA: 12] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/05/2018] [Accepted: 10/21/2018] [Indexed: 12/21/2022]
Abstract
Several studies have established that Major depressive disorder is associated with excess inflammation with an elevation of both pro and anti-inflammatory cytokines in major depressive disorder. In addition, individuals with major depressive disorder are at higher risk of developing coronary artery disease. The role of innate immunity and NFκB-mediated inflammation in depression and its increased association with coronary artery disease is yet to be fully elucidated. Polymorphisms in the Nucleotide-Binding Oligomerization Domain, Leucine Rich Repeat and Pyrin Domain Containing 12 (NLRP12), are associated with depression and coronary artery disease in trauma exposed individuals. In a cohort of Vietnam War veterans (n = 299) NLRP12 polymorphisms were analysed for association with depression and coronary calcium scores. The NLRP12 polymorphism, rs34436714 was associated with a higher DASS21 Score for depression (p = 0.037). NLRP12 polymorphisms rs34971363 and rs6509825 (p = 0.022 and p = 0.020) were associated with raised coronary calcium score. To our knowledge, this is the first time rs34436714 has been investigated in Vietnam veterans identifying AC as a risk genotype for depression in Caucasian cohorts. It is also the first time the rs34971363 (CG) and rs6509825 (CT) genotype have been associated with raised coronary calcium score.
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Affiliation(s)
- Wole Akosile
- School of Psychology and Counselling, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia; Gallipoli Medical Research Institute, Greenslopes Private Hospital, Newdegate Street, Greenslopes, Queensland 4120, Australia.
| | - Joanne Voisey
- School of Biomedical Sciences, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Bruce Lawford
- School of Biomedical Sciences, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - David Colquhounc
- Gallipoli Medical Research Institute, Greenslopes Private Hospital, Newdegate Street, Greenslopes, Queensland 4120, Australia
| | - Ross McD Young
- School of Psychology and Counselling, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia; Gallipoli Medical Research Institute, Greenslopes Private Hospital, Newdegate Street, Greenslopes, Queensland 4120, Australia
| | - Divya Mehta
- School of Psychology and Counselling, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
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Sim HW, Thong EH, Tan HC, Low AF, Lee CH, Chan MY, Tay EL, Loh PH, Chan KH, Loh JP. Clinical Outcomes One Year and Beyond After Combination Sirolimus-Eluting Endothelial Progenitor Cell Capture Stenting During Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction. Cardiovasc Revasc Med 2018; 20:739-743. [PMID: 30442536 DOI: 10.1016/j.carrev.2018.11.004] [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] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 09/09/2018] [Accepted: 11/01/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND/PURPOSE Primary percutaneous coronary intervention (PCI) during acute ST-segment elevation myocardial infarction (STEMI) represents a thrombotic milieu and is associated with delayed healing after stenting. The pro-healing combination sirolimus eluting endothelial progenitor cell (EPC) capture stents encourage early endothelialization after stenting and may be beneficial in the STEMI population. We aim to evaluate the clinical outcomes one year and beyond for patients with STEMI who received the combination sirolimus eluting EPC capture stents during primary PCI. METHODS/MATERIAL All STEMI patients implanted with combination sirolimus eluting EPC capture stents during primary PCI from November 2013 to December 2016 were enrolled. The primary outcome was target lesion failure (TLF) at in-hospital, one-month, one-year and beyond one year. RESULTS A total of 260 consecutive STEMI patients (283 lesions) were implanted with 313 combination sirolimus eluting EPC capture stents during primary PCI. Mean age was 56.1 ± 11.2 years and 88.8% were male. One in ten patients (10.9%) had cardiogenic shock on presentation, 7.3% needed mechanical ventilation and 7.7% had intra-aortic balloon pump inserted. A total of 97.9% of lesions achieve final TIMI 3 flow. Device success was seen in all patients. At extended follow up period (median 23.4 months), the clinical outcomes were TLF 8.8%, major adverse cardiovascular events 10.8%, cardiac mortality 4.2%, target vessel myocardial infarction 3.4%, target lesion revascularization 3.8%, and definite stent thrombosis 1.9%. CONCLUSIONS This study demonstrated acceptable clinical outcomes for an all-comers STEMI patients undergoing primary PCI with the use of combination sirolimus eluting EPC cell capture stents.
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Affiliation(s)
- Hui Wen Sim
- Department of Cardiology, National University Heart Center, Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 9, 119228, Singapore
| | - Elizabeth H Thong
- Department of Cardiology, National University Heart Center, Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 9, 119228, Singapore
| | - Huay Cheem Tan
- Department of Cardiology, National University Heart Center, Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 9, 119228, Singapore
| | - Adrian F Low
- Department of Cardiology, National University Heart Center, Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 9, 119228, Singapore
| | - Chi-Hang Lee
- Department of Cardiology, National University Heart Center, Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 9, 119228, Singapore
| | - Mark Y Chan
- Department of Cardiology, National University Heart Center, Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 9, 119228, Singapore
| | - Edgar L Tay
- Department of Cardiology, National University Heart Center, Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 9, 119228, Singapore
| | - Poay Huan Loh
- Department of Cardiology, National University Heart Center, Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 9, 119228, Singapore
| | - Koo Hui Chan
- Department of Cardiology, National University Heart Center, Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 9, 119228, Singapore
| | - Joshua P Loh
- Department of Cardiology, National University Heart Center, Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 9, 119228, Singapore.
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Watanabe R, Hilhorst M, Zhang H, Zeisbrich M, Berry GJ, Wallis BB, Harrison DG, Giacomini JC, Goronzy JJ, Weyand CM. Glucose metabolism controls disease-specific signatures of macrophage effector functions. JCI Insight 2018; 3:123047. [PMID: 30333306 PMCID: PMC6237479 DOI: 10.1172/jci.insight.123047] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [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: 06/20/2018] [Accepted: 09/11/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND In inflammatory blood vessel diseases, macrophages represent a key component of the vascular infiltrates and are responsible for tissue injury and wall remodeling. METHODS To examine whether inflammatory macrophages in the vessel wall display a single distinctive effector program, we compared functional profiles in patients with either coronary artery disease (CAD) or giant cell arteritis (GCA). RESULTS Unexpectedly, monocyte-derived macrophages from the 2 patient cohorts displayed disease-specific signatures and differed fundamentally in metabolic fitness. Macrophages from CAD patients were high producers for T cell chemoattractants (CXCL9, CXCL10), the cytokines IL-1β and IL-6, and the immunoinhibitory ligand PD-L1. In contrast, macrophages from GCA patients upregulated production of T cell chemoattractants (CXCL9, CXCL10) but not IL-1β and IL-6, and were distinctly low for PD-L1 expression. Notably, disease-specific effector profiles were already identifiable in circulating monocytes. The chemokinehicytokinehiPD-L1hi signature in CAD macrophages was sustained by excess uptake and breakdown of glucose, placing metabolic control upstream of inflammatory function. CONCLUSIONS We conclude that monocytes and macrophages contribute to vascular inflammation in a disease-specific and discernible pattern, have choices to commit to different functional trajectories, are dependent on glucose availability in their immediate microenvironment, and possess memory in their lineage commitment. FUNDING Supported by the NIH (R01 AR042527, R01 HL117913, R01 AI108906, P01 HL129941, R01 AI108891, R01 AG045779 U19 AI057266, R01 AI129191), I01 BX001669, and the Cahill Discovery Fund.
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Affiliation(s)
- Ryu Watanabe
- Department of Medicine, Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, California, USA
| | - Marc Hilhorst
- Department of Medicine, Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, California, USA
- Department of Internal Medicine, Academisch Medisch Centrum Universiteit van Amsterdam, Amsterdam, Netherlands
| | - Hui Zhang
- Department of Medicine, Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, California, USA
| | - Markus Zeisbrich
- Department of Medicine, Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, California, USA
| | - Gerald J. Berry
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Barbara B. Wallis
- Department of Medicine, Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, California, USA
| | - David G. Harrison
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - John C. Giacomini
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California USA
| | - Jörg J. Goronzy
- Department of Medicine, Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, California, USA
| | - Cornelia M. Weyand
- Department of Medicine, Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, California, USA
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Dadmanesh M, Aghajani H, Fadaei R, Ghorban K. Lower serum levels of Meteorin-like/Subfatin in patients with coronary artery disease and type 2 diabetes mellitus are negatively associated with insulin resistance and inflammatory cytokines. PLoS One 2018; 13:e0204180. [PMID: 30212581 PMCID: PMC6136801 DOI: 10.1371/journal.pone.0204180] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 09/03/2018] [Indexed: 01/16/2023] Open
Abstract
Meteorin-like (Metrnl) is a newly discovered adipokine with favorable effect on insulin sensitivity. Previous studies have reported lower levels of Metrnl in obese patients. However, there is conflicting data regarding its circulating levels in type 2 diabetes mellitus (T2DM) and there is no data in patients with coronary artery disease (CAD). The aim of the present study was to evaluate the Metrnl serum level in patients with T2DM and CAD, and also to evaluate the serum levels of Metrnl with serum levels of adiponectin, IL-6 and TNF-α in patients. This study was conducted on 66 patients with CAD, 63 T2DM patients and 41 controls. The serum levels of Metrnl, adiponectin, IL-6 and TNF-α were measured using ELISA techniques. The serum levels of Metrnl were found to be lower in CAD (75.18 ± 28.48 pg/mL) and T2DM patients (73.89 ± 33.60 pg/mL) compared to the control group (95.33 ± 32.56 pg/mL) (p < 0.005 and p<0.003, respectively). Additionally, adiponectin decreased in CAD and T2DM patients as compared to the control group, while IL-6 and TNF-α were higher in CAD and T2DM patients. Metrnl showed independent association with the risk of CAD and T2DM presence. Furthermore, Metrnl illustrated a negative correlation with IL-6 and TNF-α in both CAD patients and also with BMI, insulin resistance, IL-6 and TNF-α in T2DM patients. Metrnl showed an association with CAD and T2DM presence and with components of their pathogenesis such as inflammation and insulin resistance. These results suggested a possible interaction between Metrnl and the pathogenesis of CAD and T2DM, however more studies are needed to prove this concept.
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Affiliation(s)
- Maryam Dadmanesh
- Department of Infectious Diseases, School of Medicine, Aja University of Medical Sciences, Tehran, IR, Iran
| | - Hassan Aghajani
- Interventional Cardiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Reza Fadaei
- Department of Biochemistry, School of Medicine, Aja University of Medical Sciences, Tehran, IR, Iran
- * E-mail: (RF); (KG)
| | - Khodayar Ghorban
- Department of Immunology, School of Medicine, Aja University of Medical Sciences, Tehran, IR, Iran
- * E-mail: (RF); (KG)
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Fioranelli M, Bottaccioli AG, Bottaccioli F, Bianchi M, Rovesti M, Roccia MG. Stress and Inflammation in Coronary Artery Disease: A Review Psychoneuroendocrineimmunology-Based. Front Immunol 2018; 9:2031. [PMID: 30237802 PMCID: PMC6135895 DOI: 10.3389/fimmu.2018.02031] [Citation(s) in RCA: 164] [Impact Index Per Article: 27.3] [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: 01/31/2018] [Accepted: 08/17/2018] [Indexed: 01/08/2023] Open
Abstract
Recent findings have deeply changed the current view of coronary heart disease, going beyond the simplistic model of atherosclerosis as a passive process involving cholesterol build-up in the subintimal space of the arteries until their final occlusion and/or thrombosis and instead focusing on the key roles of inflammation and the immune system in plaque formation and destabilization. Chronic inflammation is a typical hallmark of cardiac disease, worsening outcomes irrespective of serum cholesterol levels. Low-grade chronic inflammation correlates with higher incidence of several non-cardiac diseases, including depression, and chronic depression is now listed among the most important cardiovascular risk factors for poor prognosis among patients with myocardial infarction. In this review, we include recent evidence describing the immune and endocrine properties of the heart and their critical roles in acute ischaemic damage and in post-infarct myocardial remodeling. The importance of the central and autonomic regulation of cardiac functions, namely, the neuro-cardiac axis, is extensively explained, highlighting the roles of acute and chronic stress, circadian rhythms, emotions and the social environment in triggering acute cardiac events and worsening heart function and metabolism in chronic cardiovascular diseases. We have also included specific sections related to stress-induced myocardial ischaemia measurements and stress cardiomyopathy. The complex network of reciprocal interconnections between the heart and the main biological systems we have presented in this paper provides a new vision of cardiovascular science based on psychoneuroendocrineimmunology.
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Affiliation(s)
- Massimo Fioranelli
- Department of Nuclear Physics, Sub-Nuclear and Radiation, Guglielmo Marconi University, Rome, Italy
- Società Italiana di Psiconeuroendocrinoimmunologia, Rome, Italy
| | - Anna G. Bottaccioli
- Società Italiana di Psiconeuroendocrinoimmunologia, Rome, Italy
- Department of Internal Medicine, Sapienza University, Rome, Italy
| | - Francesco Bottaccioli
- Società Italiana di Psiconeuroendocrinoimmunologia, Rome, Italy
- Department of Clinical Medicine, University of l'Aquila, L'Aquila, Italy
- Department of Neurosciences “Rita Levi Montalcini”, University of Turin, Rome, Italy
| | - Maria Bianchi
- Department of Nuclear Physics, Sub-Nuclear and Radiation, Guglielmo Marconi University, Rome, Italy
| | - Miriam Rovesti
- Department of Dermatology, University of Parma, Parma, Italy
| | - Maria G. Roccia
- Department of Nuclear Physics, Sub-Nuclear and Radiation, Guglielmo Marconi University, Rome, Italy
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Komiya Y, Soejima M, Tezuka D, Kohsaka H. Early Detection and Intervention of Coronary Artery Involvement in Immunoglobulin G4-related Disease. Intern Med 2018; 57:617-622. [PMID: 29151498 PMCID: PMC5849564 DOI: 10.2169/internalmedicine.7816-16] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 07/03/2017] [Indexed: 12/24/2022] Open
Abstract
A 59-year-old man with swollen submandibular glands developed an aortic aneurysm requiring aortic prosthesis implantation. Echocardiography performed to evaluate the cardiac function before the surgery incidentally revealed masses around the coronary arteries. The serum IgG4 levels were increased. A post-operational pathological examination of the abdominal aneurysms revealed infiltration of plasma cells, with the ratio of IgG4/IgG-positive cells being >80%. The patient was diagnosed with IgG4-related disease (RD) with coronary artery involvement. He was treated successfully with corticosteroid before any associated cardiovascular events occurred. Given the poor prognosis of IgG4-RD-associated coronary artery involvement, this case emphasizes the importance of the early assessment with echocardiography, even if patients have no cardiovascular symptoms.
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Affiliation(s)
- Yoji Komiya
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan
| | - Makoto Soejima
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan
| | - Daisuke Tezuka
- Department of Cardiovascular Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan
| | - Hitoshi Kohsaka
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan
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Undas A, Jankowski M, Twardowska M, Padjas A, Jakubowski H, Szczeklik A. Antibodies to N-homocysteinylated albumin as a marker for earlyonset coronary artery disease in men. Thromb Haemost 2017; 93:346-50. [PMID: 15711753 DOI: 10.1160/th04-08-0493] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [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: 11/05/2022]
Abstract
Summary
N-homocysteinylated (Nε-Hcy) proteins and corresponding antibodies have recently been discovered in humans and animals. Increased autoimmune response to Nε -Hcy-proteins has been reported in stroke patients. The aim of the present study was to investigate whether antibodies against N-homocysteinylated albumin are associated with coronary artery disease (CAD).We studied 88 male patients aged 50 years or under with angiographically documented CAD and 100 age-matched apparently healthy men as controls. Serum levels of IgG antibodies against Nε-Hcy-albumin were determined using an enzymelinked immunosorbent assay. Seropositivity to anti-Nε -Hcy-albumin antibodies was 5-fold more frequent in CAD patients than in controls (52.3 % vs 10.0 %; p<0.0001). Plasma Hcy levels in CAD patients were also significantly higher in the former than in the latter group (medians, 13.0 μ M vs 12.1 μ M; p=0.026). Importantly, 41.2% of subjects with plasma total Hcy >14.5 mM were seropositive compared with 25.5 % of normohomocysteinemic individuals (p=0.048).There was a weak correlation between anti-Nε-Hcy-albumin antibodies and Hcy levels (r=0.16; p=0.03). By multivariate logistic regression analysis, seropositivity to anti-Nε-Hcy-albumin antibodies was an independent predictor of early CAD (OR, 14.82; 95% CI, 4.47 to 49.19; p=0.00002). Interestingly, anti-Nε-Hcy-albumin antibodies were associated with C-reactive protein levels (r=0.24; p=0.002). Seropositivity to anti-Nε-Hcy-albumin antibodies showed no association with the MTHFR C677T polymorphism. Our results suggest that seropositivity to antibodies against Nε-homocysteinylated albumin is associated with early-onset CAD. An autoimmune response to Nε-Hcy-albumin may represent a novel mechanism involved in the early development of CAD.
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Affiliation(s)
- Anetta Undas
- Department of Medicine, Jagiellonian University School of Medicine, 8 Skawinska Street, 31-066 Cracow, Poland
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Abstract
Immunoglobulin G4 (IgG4)-related disease is a systemic inflammatory disorder that was first described in patients with autoimmune pancreatitis. Although IgG4-related disease is thought to involve the cardiovascular system, case reports describing coronary artery involvement are relatively rare. We describe a patient who was previously diagnosed with autoimmune pancreatitis and found to have coronary periarteritis and luminal narrowing. After the initiation of steroid treatment, the patient's coronary periarteritis and luminal stenosis were both ameliorated with an improvement in the serum IgG4 concentration. The present findings collectively suggest that IgG4-related immuno-inflammation may have a role in the development of coronary periarteritis and luminal atherosclerosis.
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Affiliation(s)
- Aiko Sakamoto
- Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, Japan
- Division for Health Service Promotion, University of Tokyo, Japan
| | - Tomofumi Tanaka
- Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, Japan
- Department of Cardiology, Sakakibara Heart Institute, Japan
| | - Kenji Hirano
- Department of Gastroenterology, University of Tokyo Graduate School of Medicine, Japan
- Department of Gastroenterology, Tokyo Takanawa Hospital, Japan
| | - Kazuhiko Koike
- Department of Gastroenterology, University of Tokyo Graduate School of Medicine, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, Japan
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Song CL, Wang JP, Xue X, Liu N, Zhang XH, Zhao Z, Liu JG, Zhang CP, Piao ZH, Liu Y, Yang YB. Effect of Circular ANRIL on the Inflammatory Response of Vascular Endothelial Cells in a Rat Model of Coronary Atherosclerosis. Cell Physiol Biochem 2017; 42:1202-1212. [PMID: 28683453 DOI: 10.1159/000478918] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Accepted: 04/13/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS This study aims to investigate the role of circular antisense non-coding RNA at the INK4 locus (cANRIL) in the inflammatory response of vascular endothelial cells (ECs) in a rat model of coronary atherosclerosis (AS). A rat model of AS was established with rats that were injected with a large dose of vitamin D3 and fed a high-fat diet. METHODS Sixty Wistar rats were randomly assigned into control, model, empty vector, over-expressed cANRIL and low-expressed cANRIL groups (12 rats in each group). Sixteen weeks later, the ultrastructure of their coronary arteries was observed via transmission electron microscopy. Rat serum lipid levels were analyzed using an automatic biochemical analyzer, and their atherogenic index (AI) values were calculated. Hematoxylin and eosin staining was used to observe the endothelial morphology of rats. Additionally, rat EC apoptosis was tested via a TUNEL assay. Enzyme-linked immunosorbent assays (ELISAs) were applied to measure serum levels of interleukin-1 (IL-1), IL-6, matrix metalloproteinase-9 (MMP-9) and C-reactive protein (CRP). The cANRIL, Bax, bcl-2 and caspase-3 mRNA expression levels were measured with a quantitative real-time polymerase chain reaction (qRT-PCR). The protein expression levels of Bax, bcl-2 and caspase-3 were detected using immunohistochemistry. RESULTS In the control group, ECs were closely arranged with normal structures, and there was no proliferation. In the model, empty vector and over-expressed cANRIL groups, some cells were not present, and atherosclerotic plaques and thrombi appeared. However, in the under-expressed cANRIL group, the cells had a normal structure. Compared with the model and empty vector groups, the levels of total cholesterol (CHOL), triglycerides (TGs), low density lipoprotein (LDL), IL-1, IL-6, MMP-9, CRP, cANRIL, Bax, and caspase-3, AI values, and rates of EC apoptosis decreased in the low-expressed cANRIL group, while HDL (high density lipoprotein) levels and mRNA and protein expression levels of bcl-2 were increased. The changes in expression levels in the over-expressed cANRIL group were the opposite of those in the low-expressed cANRIL group. CONCLUSIONS Our study provides evidence that reduced cANRIL expression could prevent coronary AS by reducing vascular EC apoptosis and inflammatory factor expression.
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Watanabe R, Shirai T, Namkoong H, Zhang H, Berry GJ, Wallis BB, Schaefgen B, Harrison DG, Tremmel JA, Giacomini JC, Goronzy JJ, Weyand CM. Pyruvate controls the checkpoint inhibitor PD-L1 and suppresses T cell immunity. J Clin Invest 2017; 127:2725-2738. [PMID: 28604383 PMCID: PMC5490755 DOI: 10.1172/jci92167] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [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: 12/07/2016] [Accepted: 04/27/2017] [Indexed: 01/12/2023] Open
Abstract
Patients with coronary artery disease (CAD) are at high risk for reactivation of the varicella zoster virus (VZV) and development of herpes zoster (HZ). Here, we found that macrophages from patients with CAD actively suppress T cell activation and expansion, leading to defective VZV-specific T cell immunity. Monocyte-derived and plaque-infiltrating macrophages from patients with CAD spontaneously expressed high surface density of the immunoinhibitory ligand programmed death ligand-1 (PD-L1), thereby providing negative signals to programmed death-1+ (PD-1+) T cells. We determined that aberrant PD-L1 expression in patient-derived macrophages was metabolically controlled. Oversupply of the glycolytic intermediate pyruvate in mitochondria from CAD macrophages promoted expression of PD-L1 via induction of the bone morphogenetic protein 4/phosphorylated SMAD1/5/IFN regulatory factor 1 (BMP4/p-SMAD1/5/IRF1) signaling pathway. Thus, CAD macrophages respond to nutrient excess by activating the immunoinhibitory PD-1/PD-L1 checkpoint, leading to impaired T cell immunity. This finding indicates that metabolite-based immunotherapy may be a potential strategy for restoring adaptive immunity in CAD.
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Affiliation(s)
- Ryu Watanabe
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Tsuyoshi Shirai
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hong Namkoong
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Hui Zhang
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Gerald J. Berry
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Barbara B. Wallis
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Benedikt Schaefgen
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - David G. Harrison
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Jennifer A. Tremmel
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - John C. Giacomini
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Jörg J. Goronzy
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Cornelia M. Weyand
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
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Prasad A, Clopton P, Ayers C, Khera A, de Lemos JA, Witztum JL, Tsimikas S. Relationship of Autoantibodies to MDA-LDL and ApoB-Immune Complexes to Sex, Ethnicity, Subclinical Atherosclerosis, and Cardiovascular Events. Arterioscler Thromb Vasc Biol 2017; 37:1213-1221. [PMID: 28473443 PMCID: PMC5500201 DOI: 10.1161/atvbaha.117.309101] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [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: 02/14/2017] [Accepted: 04/18/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Modifications of lipid constituents within atherosclerotic lesions generate neoepitopes that activate innate and adaptive immune responses. We aimed to define the prevalence, distribution, and relationship of autoantibody titers of oxidized lipoproteins to subclinical atherosclerosis and major adverse cardiovascular events (MACE) in different ethnic groups. APPROACH AND RESULTS IgG and IgM autoantibodies to malondialdehyde-modified low-density lipoprotein (MDA-LDL) and apolipoprotein B-100-immune complexes were measured in 3509 individuals (1814 blacks, 1031 whites, 589 Hispanics, and 85 no race identifier) from the Dallas Heart Study with median 10.5-year follow-up. Coronary artery calcium score, abdominal aortic plaque by magnetic resonance imaging, and MACE were quantified. IgG MDA-LDL and IgG and IgM apolipoprotein B-100-immune complexes were significantly different between groups, with blacks having the highest levels of IgG MDA-LDL and IgG apolipoprotein B-100-immune complexes and Hispanics having the highest levels of IgM apolipoprotein B-100-immune complexes (P<0.001 for all). IgGs tended to be higher and IgMs lower with age for all markers. In multivariable-adjusted binary logistic regression analysis, a doubling of IgG MDA-LDL levels was associated with prevalent coronary artery calcium score >10 Agatston units (odds ratio [95% confidence interval], 1.21 [1.07-1.36]; P=0.002). Multivariable-adjusted Cox regression analysis revealed that IgG MDA-LDL was independently associated with time to incident MACE in the entire group (hazard ratio [95% confidence interval], 1.76 [1.16-2.72]; P=0.009 for fourth versus first quartile). This effect was particularly prominent in black subjects (hazard ratio [95% confidence interval], 2.52 [1.39-4.57]; P=0.002). CONCLUSIONS Autoantibodies to oxidized lipoproteins and immune complexes with apoB-100 lipoproteins vary significantly by sex, age, and ethnicity. Higher baseline IgG MDA-LDL titers independently associate with new MACE. These findings may contribute to the understanding of differences in ethnic-specific MACE events.
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Affiliation(s)
- Anand Prasad
- From the Division of Cardiology, Department of Medicine, The University of Texas Health Science Center San Antonio (A.P.); Veterans Affairs Medical Center, San Diego, CA (P.C.); Division of Cardiology, University of Texas Southwestern Medical Center at Dallas (C.A., A.K., J.A.d.L.); Division of Endocrinology and Metabolism (J.L.W.) and Department of Medicine (S.T.), University of California San Diego, La Jolla; and Division of Cardiovascular Diseases, Sulpizio Cardiovascular Center, La Jolla, CA (S.T.)
| | - Paul Clopton
- From the Division of Cardiology, Department of Medicine, The University of Texas Health Science Center San Antonio (A.P.); Veterans Affairs Medical Center, San Diego, CA (P.C.); Division of Cardiology, University of Texas Southwestern Medical Center at Dallas (C.A., A.K., J.A.d.L.); Division of Endocrinology and Metabolism (J.L.W.) and Department of Medicine (S.T.), University of California San Diego, La Jolla; and Division of Cardiovascular Diseases, Sulpizio Cardiovascular Center, La Jolla, CA (S.T.)
| | - Colby Ayers
- From the Division of Cardiology, Department of Medicine, The University of Texas Health Science Center San Antonio (A.P.); Veterans Affairs Medical Center, San Diego, CA (P.C.); Division of Cardiology, University of Texas Southwestern Medical Center at Dallas (C.A., A.K., J.A.d.L.); Division of Endocrinology and Metabolism (J.L.W.) and Department of Medicine (S.T.), University of California San Diego, La Jolla; and Division of Cardiovascular Diseases, Sulpizio Cardiovascular Center, La Jolla, CA (S.T.)
| | - Amit Khera
- From the Division of Cardiology, Department of Medicine, The University of Texas Health Science Center San Antonio (A.P.); Veterans Affairs Medical Center, San Diego, CA (P.C.); Division of Cardiology, University of Texas Southwestern Medical Center at Dallas (C.A., A.K., J.A.d.L.); Division of Endocrinology and Metabolism (J.L.W.) and Department of Medicine (S.T.), University of California San Diego, La Jolla; and Division of Cardiovascular Diseases, Sulpizio Cardiovascular Center, La Jolla, CA (S.T.)
| | - James A de Lemos
- From the Division of Cardiology, Department of Medicine, The University of Texas Health Science Center San Antonio (A.P.); Veterans Affairs Medical Center, San Diego, CA (P.C.); Division of Cardiology, University of Texas Southwestern Medical Center at Dallas (C.A., A.K., J.A.d.L.); Division of Endocrinology and Metabolism (J.L.W.) and Department of Medicine (S.T.), University of California San Diego, La Jolla; and Division of Cardiovascular Diseases, Sulpizio Cardiovascular Center, La Jolla, CA (S.T.)
| | - Joseph L Witztum
- From the Division of Cardiology, Department of Medicine, The University of Texas Health Science Center San Antonio (A.P.); Veterans Affairs Medical Center, San Diego, CA (P.C.); Division of Cardiology, University of Texas Southwestern Medical Center at Dallas (C.A., A.K., J.A.d.L.); Division of Endocrinology and Metabolism (J.L.W.) and Department of Medicine (S.T.), University of California San Diego, La Jolla; and Division of Cardiovascular Diseases, Sulpizio Cardiovascular Center, La Jolla, CA (S.T.)
| | - Sotirios Tsimikas
- From the Division of Cardiology, Department of Medicine, The University of Texas Health Science Center San Antonio (A.P.); Veterans Affairs Medical Center, San Diego, CA (P.C.); Division of Cardiology, University of Texas Southwestern Medical Center at Dallas (C.A., A.K., J.A.d.L.); Division of Endocrinology and Metabolism (J.L.W.) and Department of Medicine (S.T.), University of California San Diego, La Jolla; and Division of Cardiovascular Diseases, Sulpizio Cardiovascular Center, La Jolla, CA (S.T.).
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McCarty MF, O'Keefe JH, DiNicolantonio JJ. Interleukin-1beta may act on hepatocytes to boost plasma homocysteine - The increased cardiovascular risk associated with elevated homocysteine may be mediated by this cytokine. Med Hypotheses 2017; 102:78-81. [PMID: 28478836 DOI: 10.1016/j.mehy.2017.03.022] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 03/11/2017] [Indexed: 11/17/2022]
Abstract
The results of multi-center trials of B vitamin supplementation reveal that, whereas moderately elevated homocysteine predicts increased risk for coronary disease, it does not play a mediating role in this regard. This essay proposes that interleukin-1beta can act on hepatocytes to suppress expression of the hepatocyte-specific forms of methionine adenosyltransferase; this in turn can be expected to decrease hepatic activity of cystathionine-β-synthase, leading to an increase in plasma homocysteine. It is further proposed that interleukin-1beta (IL-1β) is a true mediating risk factor for cardiovascular disease, and that elevated homocysteine predicts coronary disease because it can serve as a marker for increased IL-1β activity. Potent statin therapy may decrease IL-1β production by suppressing inflammasome activation - thereby accounting for the marked protection from cardiovascular events observed in the classic JUPITER study, in which the enrolled subjects had low-normal Low Density Lipoprotein cholesterol but elevated C-reactive protein.
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Ward-Caviness CK, Neas LM, Blach C, Haynes CS, LaRocque-Abramson K, Grass E, Dowdy ZE, Devlin RB, Diaz-Sanchez D, Cascio WE, Miranda ML, Gregory SG, Shah SH, Kraus WE, Hauser ER. A genome-wide trans-ethnic interaction study links the PIGR-FCAMR locus to coronary atherosclerosis via interactions between genetic variants and residential exposure to traffic. PLoS One 2017; 12:e0173880. [PMID: 28355232 PMCID: PMC5371323 DOI: 10.1371/journal.pone.0173880] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 02/28/2017] [Indexed: 12/31/2022] Open
Abstract
Air pollution is a worldwide contributor to cardiovascular disease mortality and morbidity. Traffic-related air pollution is a widespread environmental exposure and is associated with multiple cardiovascular outcomes such as coronary atherosclerosis, peripheral arterial disease, and myocardial infarction. Despite the recognition of the importance of both genetic and environmental exposures to the pathogenesis of cardiovascular disease, studies of how these two contributors operate jointly are rare. We performed a genome-wide interaction study (GWIS) to examine gene-traffic exposure interactions associated with coronary atherosclerosis. Using race-stratified cohorts of 538 African-Americans (AA) and 1562 European-Americans (EA) from a cardiac catheterization cohort (CATHGEN), we identify gene-by-traffic exposure interactions associated with the number of significantly diseased coronary vessels as a measure of chronic atherosclerosis. We found five suggestive (P<1x10-5) interactions in the AA GWIS, of which two (rs1856746 and rs2791713) replicated in the EA cohort (P < 0.05). Both SNPs are in the PIGR-FCAMR locus and are eQTLs in lymphocytes. The protein products of both PIGR and FCAMR are implicated in inflammatory processes. In the EA GWIS, there were three suggestive interactions; none of these replicated in the AA GWIS. All three were intergenic; the most significant interaction was in a regulatory region associated with SAMSN1, a gene previously associated with atherosclerosis and B cell activation. In conclusion, we have uncovered several novel genes associated with coronary atherosclerosis in individuals chronically exposed to increased ambient concentrations of traffic air pollution. These genes point towards inflammatory pathways that may modify the effects of air pollution on cardiovascular disease risk.
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Affiliation(s)
- Cavin K. Ward-Caviness
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States of America
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany
- National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Chapel Hill, NC, United States of America
| | - Lucas M. Neas
- National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Chapel Hill, NC, United States of America
| | - Colette Blach
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States of America
| | - Carol S. Haynes
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States of America
| | - Karen LaRocque-Abramson
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States of America
| | - Elizabeth Grass
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States of America
| | - Z. Elaine Dowdy
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States of America
| | - Robert B. Devlin
- National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Chapel Hill, NC, United States of America
| | - David Diaz-Sanchez
- National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Chapel Hill, NC, United States of America
| | - Wayne E. Cascio
- National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Chapel Hill, NC, United States of America
| | - Marie Lynn Miranda
- National Center for Geospatial Medicine, Rice University, Houston, TX, United States of America
| | - Simon G. Gregory
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States of America
| | - Svati H. Shah
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States of America
- Division of Cardiology, Duke University School of Medicine, Durham, NC, United States of America
| | - William E. Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States of America
- Division of Cardiology, Duke University School of Medicine, Durham, NC, United States of America
| | - Elizabeth R. Hauser
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States of America
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, United States of America
- Cooperative Studies Program Epidemiology Center-Durham, Veterans Affairs Medical Center, Durham, NC, United States of America
- * E-mail:
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Bazdyrev ED, Polikutina OM, Kalichenko NA, Slepynina YS, Uchasova EG, Pavlova VY, Barbarash OL. [RELATIONSHIP BETWEEN SMOKING AND INDICATORS OF SYSTEMIC INFLAMMATION IN PATIENTS WITH CORONARY HEART DISEASE]. Klin Med (Mosk) 2017; 95:264-271. [PMID: 30303364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM To estimate the severity of systemic inflammation in subjects with coronary artery disease (CAD) without bronchopulmonary system comorbidity depending on smoking factor. MATERIALS AND METHODS The subjects were divided into groups depending on smoking factor. We estimated the following laboratory markers of nonspecific inflammation: interleukine (IL)-12, -1β, tumour necrosis factor-α, matrix metalloproteinase-9, C-reactive protein. The examination of lungs respiratory function included spirometry, body plethysmography and assessment of diffusing lung capacity. RESULTS 29.9% of the subjects with CAD smoked, 40% reported discontinuation of smoking in their histories. Smoking in CAD subjects without the history of bronchopulmonary system comorbidity was associated with a higher level of inflammatory markers (IL-12, IL-1β, TNF-α, ММР-9 and CRP) than in subjects who ceased to smoke and those who have never smoked. No differences in the levels of inflammatory markers were revealed in subjects who had smoked before and never smoked. CONCLUSION Smoking is widespread among CAD subjects. It is associated with a higher level of markers of nonspecific inflammation as compared to subjects who have never smoked before or ceased smoking.
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Ghayour-Mobarhan M, Lamb DJ, Vaidya N, Livingstone C, Wang T, Ferns GAA. Heat Shock Protein Antibody Titers Are Reduced by Statin Therapy in Dyslipidemic Subjects: A Pilot Study. Angiology 2016; 56:61-8. [PMID: 15678257 DOI: 10.1177/000331970505600108] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 11/15/2022]
Abstract
Antibody titers to heat shock protein (Hsp)-60 and -65 are positively related to risk of vascular disease and cardiovascular endpoints. There are few data on the factors that regulate the levels of these antibodies. It is known that the statins have antiinflammatory and immunoregulatory properties. The authors examined the effects of 2 statins, simvastatin (Zocor®) and atorvastatin (Lipitor®) on antibody titers to Hsp-60, -65, and -70 in a group of dyslipidemic patients. Twenty patients attending a lipid clinic, and previously not receiving lipid-lowering treatment, were treated with 10 mg of simvastatin (n=11) or atorvastatin (n=9) for 4 months. An additional 14 patients were recruited from the same clinic at the same hospital as a control group. The medication of these latter patients was unaltered for 4 months and the same parameters were measured as for the statin group. Antibody titers to Hsp-60, -65, and -70 were measured by enzyme-linked immunosorbent assay and lipoprotein profile and highly sensitive serum C-reactive protein (CRP) were measured by routine methods before and after treatment. Pretreatment and posttreatment data were compared by paired t or Mann-Whitney tests. Overall statin treatment was associated with a significant reduction in median antibody titers to Hsp-60 (17.2%, p=0.03), Hsp-65 (15.9%, p=0.003) and Hsp-70 (8.3%, p=0.006), but not in control patients. Both statins caused a reduction in median serum CRP concentrations (45% overall, p<0.05), but significant changes were not observed in the control patients. The effects on Hsp antibody titers were not related to changes in serum CRP concentrations (p>0.05). However, there was a significant correlation between changes in antibody titers to Hsp-60 vs Hsp-65 (p<0.01), Hsp-60 vs Hsp-70 (p<0.05), and Hsp-65 vs Hsp-70 (p<0.001). Statin treatment was associated with a reduction in antibody titers to Hsp-60, -65, and -70. This reduction is not fully explained by the antiinflammatory effects of the statins but may be due to their other immunomodulatory properties.
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Affiliation(s)
- M Ghayour-Mobarhan
- Centre for Clinical Science and Measurement, School of Biomedical and Molecular Science, University of Surrey, Guildford, Surrey, UK
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Korkmaz C, Cansu DU, Kaşifoğlu T. Myocardial infarction in young patients (≤35 years of age) with systemic lupus erythematosus: a case report and clinical analysis of the literature. Lupus 2016; 16:289-97. [PMID: 17439937 DOI: 10.1177/0961203307078001] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [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: 11/16/2022]
Abstract
The present study aims to report a-20-year old girl with systemic lupus erythematosus (SLE) who developed myocardial infarction (MI) and also aims to review acute myocardial infarction (AMI) in young SLE cases (≤35 years) reported in the literature. We conducted a comprehensive review of the English literature from 1975 to 2006 to analyse data on MI in SLE patients who had developed AMI either at 35 or earlier. In 32 English articles, we identified 49 SLE patients, plus our case, with AMI. They consist of 41 female and nine male patients, their mean age being 24 ± 6.4 years (range of 5—35). Disease duration varied between 0 and 13 years. The lag time between the onset of the SLE manifestations and development of AMI was 7.7 ± 5.4 year (range of 1 month to 20.5 years). We divided the patients into three subgroups according to their coronary involvement type (Group I: normal coronary artery or coronary thrombosis ( n = 16); Group II: coronary aneurysm/arteritis ( n = 12); Group III: coronary atherosclerosis ( n = 22)). The lag time between the onset of the SLE manifestations and development of MI in the subgroups showed variations: Group I < Group II < Group III. Both prevalence of renal involvement and steroid therapy were higher in patients with coronary atherosclerosis than were in Group I. There were one or more risk factors for atherosclerosis in 39 SLE patients. AMI in young SLE patients may be seen, albeit rare. We suggest that clinicians should have a low threshold for cardiac evaluation in patients with SLE. Also, traditional risk factors could be managed through preventive measures. Lupus (2007) 16, 289—297.
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Affiliation(s)
- C Korkmaz
- Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.
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Abstract
Coronary artery disease (CAD), also known as ischemic heart disease (IHD), is the leading cause of mortality in the western world, with developing countries showing a similar trend. With the increased understanding of the role of the immune system and inflammation in coronary artery disease, it was shown that macrophages play a major role in this disease. Costimulatory molecules are important regulators of inflammation, and especially, the CD40L-CD40 axis is of importance in the pathogenesis of cardiovascular disease. Although it was shown that CD40 can mediate macrophage function, its exact role in macrophage biology has not gained much attention in cardiovascular disease. Therefore, the goal of this review is to give an overview on the role of macrophage-specific CD40 in cardiovascular disease, with a focus on coronary artery disease. We will discuss the function of CD40 on the macrophage and its (proposed) role in the reduction of atherosclerosis, the reduction of neointima formation, and the stimulation of arteriogenesis.
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Affiliation(s)
- Matthijs F Jansen
- Department of Molecular Cell Biology and Immunology, VU University Medical Centre, Amsterdam, The Netherlands
- Department of Medical Biochemistry, Academic Medical Centre, Meibergdreef 15, 1105AZ, Amsterdam, The Netherlands
| | - Maurits R Hollander
- Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Niels van Royen
- Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Anton J Horrevoets
- Department of Molecular Cell Biology and Immunology, VU University Medical Centre, Amsterdam, The Netherlands
| | - Esther Lutgens
- Department of Medical Biochemistry, Academic Medical Centre, Meibergdreef 15, 1105AZ, Amsterdam, The Netherlands.
- Institute for Cardiovascular Prevention (IPEK), Ludwig Maximilians University, Munich, Germany.
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