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Xu G, Shi W, Ling L, Li C, Shao F, Chen J, Wang Y. Differential expression and analysis of extrachromosomal circular DNAs as serum biomarkers in lung adenocarcinoma. J Clin Lab Anal 2022; 36:e24425. [PMID: 35441736 PMCID: PMC9169211 DOI: 10.1002/jcla.24425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 11/07/2022] Open
Abstract
Background Extrachromosomal circular DNAs (eccDNAs) increase the number of proto‐oncogenes by enhancing oncogene expression to promote tumorigenesis. However, there are limited reports on differential eccDNA expression and analysis in lung cancer, especially in lung adenocarcinoma (LAD). Methods Three LAD and three corresponding NT tissues samples were used for eccDNA next‐generation sequencing analysis, and an additional 20 were used for quantitative PCR (qPCR) evaluations. We further performed qPCR amplification using serum samples from LAD patients and healthy medical examiners. Results eccDNAs from LAD samples were mainly 200–1000 bp in length. Gene annotation analysis revealed that most eccDNAs were derived from chromosomes 1 and 2. The top‐ten increased and top‐ten decreased eccDNAs in LAD tissues were CircD‐ARPC1B, CircD‐ARPC1A, CircD‐FAM49B, CircD‐SDK1, CircD‐KCNG1, CircD‐POLR2F, CircD‐SS18L1, CircD‐SLC16A3, CircD‐CSNK1D, CircD‐KCTD1, and CircD‐TMIGD2, CircD‐PDIA5, CircD‐VAV2, CircD‐GATAD2A, CircD‐CAB39L, CircD‐KHDC1, CircD‐FOXN3, CircD‐SULT2B1, CircD‐DPP9, and CircD‐CSNK1D. qPCR demonstrated that the expression of CircD‐DZRN3 was higher in LAD tissues than in normal lung tissues, whereas CircD‐LGR6 and CircD‐UMODL1 expression levels were lower in LAD than in normal lung tissues. Furthermore, the serum CircD‐PDZRN3 level increased, while CircD‐LGR6 decreased in LAD. Receiver operating characteristic (ROC) analysis showed that area under curve (AUC) of serum CircD‐PDZRN3 (0.991), CircD‐LGR6 (0.916) was higher than that of serum carcinoembryonic antigen (CEA) (0.825), CY211 (cytokeratin 19 fragment) (0.842), SCCA(squamous cell carcinoma antigen) (0.857) for the diagnosis of LAD. Conclusions Our study first showed that several eccDNAs were aberrantly expressed in LAD, among which CircD‐PDZRN3 and CircD‐LGR6 clearly distinguished LAD patients from healthy controls, indicating their potential as biomarkers.
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Affiliation(s)
- Gang Xu
- Department of Laboratory MedicineThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Wenjing Shi
- Department of Laboratory MedicineThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Liqun Ling
- Department of Laboratory MedicineThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Changhong Li
- Department of Laboratory MedicineThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Fanggui Shao
- Department of Laboratory MedicineThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Jie Chen
- Department of ICUThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Yumin Wang
- Department of Laboratory MedicineThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
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Ding Y, Li X, Gao Q, Dong X, Kong L, Han S, Zhang T, He L. A paper-based ELISA for rapid sensitive determination of anaphylaxis-related MRGPRX2 in human peripheral blood. Anal Biochem 2021; 633:114392. [PMID: 34597615 DOI: 10.1016/j.ab.2021.114392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 08/08/2021] [Accepted: 09/21/2021] [Indexed: 11/18/2022]
Abstract
Mas-related G-protein-coupled receptor X2 (MRGPRX2) has recently been reported to be associated with anaphylaxis. Detection of MRGPRX2 levels in human peripheral blood might serve as a powerful tool for predicting the predisposition of patients to anaphylactic reactions. For rapid measurement of MRGPRX2, we established a paper-based double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) using mouse monoclonal antibody and horseradish peroxidase (HRP)-labelled rabbit polyclonal antibody as capture antibody and detection antibody, respectively. We avoided chemical functionalization of the cellulose paper by introducing bovine serum albumin (BSA) to provide COOH and NH2 groups for covalent immobilization of the capture antibody. Through amide condensation, a two-layer immobilization strategy was applied with BSA-BSA and BSA-capture antibody networks as the first and second layers, respectively. This strategy improved the quantity, activity and stability of the immobilized antibody. We then established a paper-based ELISA to detect MRGPRX2 in human peripheral blood. Our method is less laborious, easier to implement, and more cost-effective than conventional ELISA, while offering similar sensitivity, specificity, and accuracy. Therefore, it could serve as an innovative clinical point-of-care diagnostic tool, especially in areas that lack advanced clinical equipment.
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Affiliation(s)
- Yuanyuan Ding
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Xiaoqian Li
- School of Public Health, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Qingpeng Gao
- School of Public Health, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Xinyan Dong
- School of Biological and Chemical Engineering, NingboTech University, Ningbo, 315100, China
| | - Liyun Kong
- School of Public Health, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
| | - Shengli Han
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Tao Zhang
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Langchong He
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
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Jareid M, Snapkov I, Holden M, Busund LTR, Lund E, Nøst TH. The blood transcriptome prior to ovarian cancer diagnosis: A case-control study in the NOWAC postgenome cohort. PLoS One 2021; 16:e0256442. [PMID: 34449791 PMCID: PMC8396762 DOI: 10.1371/journal.pone.0256442] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 08/06/2021] [Indexed: 11/22/2022] Open
Abstract
Epithelial ovarian cancer (EOC) has a 5-year relative survival of 50%, partly because markers of early-stage disease are not available in current clinical diagnostics. The aim of the present study was to investigate whether EOC is associated with transcriptional profiles in blood collected up to 7 years before diagnosis. For this, we used RNA-stabilized whole blood, which contains circulating immune cells, from a sample of EOC cases from the population-based Norwegian Women and Cancer (NOWAC) postgenome cohort. We explored case-control differences in gene expression in all EOC (66 case-control pairs), as well as associations between gene expression and metastatic EOC (56 pairs), serous EOC (45 pairs, 44 of which were metastatic), and interval from blood sample collection to diagnosis (≤3 or >3 years; 34 and 31 pairs, respectively). Lastly, we assessed differential expression of genes associated with EOC in published functional genomics studies that used blood samples collected from newly diagnosed women. After adjustment for multiple testing, this nested case-control study revealed no significant case-control differences in gene expression in all EOC (false discovery rate q>0.96). With the exception of a few probes, the log2 fold change values obtained in gene-wise linear models were below ±0.2. P-values were lowest in analyses of metastatic EOC (80% of which were serous EOC). No common transcriptional profile was indicated by interval to diagnosis; when comparing the 100 genes with the lowest p-values in gene-wise tests in samples collected ≤3 and >3 years before EOC diagnosis, no overlap in these genes was observed. Among 86 genes linked to ovarian cancer in previous publications, our data contained expression values for 42, and of these, tests of LIME1, GPR162, STAB1, and SKAP1, resulted in unadjusted p<0.05. Although limited by sample size, our findings indicated less variation in blood gene expression between women with similar tumor characteristics.
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Affiliation(s)
- Mie Jareid
- Faculty of Health Sciences, Department of Community Medicine, UiT – The Arctic University of Norway, Tromsø, Norway
- * E-mail:
| | - Igor Snapkov
- Department of Immunology, Oslo University Hospital Rikshospitalet and University of Oslo, Oslo, Norway
| | | | - Lill-Tove Rasmussen Busund
- Faculty of Health Sciences, Department of Medical Biology, UiT – The Arctic University of Norway, Tromsø, Norway
| | - Eiliv Lund
- Faculty of Health Sciences, Department of Community Medicine, UiT – The Arctic University of Norway, Tromsø, Norway
- Cancer Registry of Norway, Oslo, Norway
| | - Therese Haugdahl Nøst
- Faculty of Health Sciences, Department of Community Medicine, UiT – The Arctic University of Norway, Tromsø, Norway
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Abstract
[Figure: see text].
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Affiliation(s)
- Huanan Shi
- Department of Anesthesiology, Baylor College of Medicine,
Houston TX, USA
- Department of Molecular Physiology and Biophysics, Baylor
College of Medicine, Houston TX, USA
| | - Bojun Zhang
- Department of Anesthesiology, Baylor College of Medicine,
Houston TX, USA
| | - Taylor Abo-Hamzy
- School of Health Professions, Baylor College of Medicine,
Houston TX, USA
| | - James W. Nelson
- Department of Anesthesiology, Baylor College of Medicine,
Houston TX, USA
- Integrated Molecular and Biomedical Sciences Graduate
Program, Baylor College of Medicine, Houston TX, USA
| | | | - Joseph F. Petrosino
- Department of Molecular Virology and Microbiology, The
Alkek Center for Metagenomics and Microbiome Research, Baylor College of Medicine,
Houston TX, USA
| | - Robert M. Bryan
- Department of Anesthesiology, Baylor College of Medicine,
Houston TX, USA
- Department of Molecular Physiology and Biophysics, Baylor
College of Medicine, Houston TX, USA
| | - David J. Durgan
- Department of Anesthesiology, Baylor College of Medicine,
Houston TX, USA
- Department of Molecular Physiology and Biophysics, Baylor
College of Medicine, Houston TX, USA
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Van Doren L, Nguyen N, Garzia C, Fletcher EK, Stevenson R, Jaramillo D, Kuliopulos A, Covic L. Lipid Receptor GPR31 (G-Protein-Coupled Receptor 31) Regulates Platelet Reactivity and Thrombosis Without Affecting Hemostasis. Arterioscler Thromb Vasc Biol 2021; 41:e33-e45. [PMID: 33267659 PMCID: PMC8108540 DOI: 10.1161/atvbaha.120.315154] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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] [Indexed: 12/23/2022]
Abstract
OBJECTIVE 12-LOX (12-lipoxygenase) produces a number of bioactive lipids including 12(S)-HETE that are involved in inflammation and platelet reactivity. The GPR31 (G-protein-coupled receptor 31) is the proposed receptor of 12(S)-HETE; however, it is not known whether the 12(S)-HETE-GPR31 signaling axis serves to enhance or inhibit platelet activity. Approach and Results: Using pepducin technology and biochemical approaches, we provide evidence that 12(S)-HETE-GPR31 signals through Gi to enhance PAR (protease-activated receptor)-4-mediated platelet activation and arterial thrombosis using both human platelets and mouse carotid artery injury models. 12(S)-HETE suppressed AC (adenylyl cyclase) activity through GPR31 and resulted in Rap1 (Ras-related protein 1) and p38 activation and low but detectable calcium flux but did not induce platelet aggregation. A GPR31 third intracellular (i3) loop-derived pepducin, GPR310 (G-protein-coupled receptor 310), significantly inhibited platelet aggregation in response to thrombin, collagen, and PAR4 agonist, AYPGKF, in human and mouse platelets but relative sparing of PAR1 agonist SFLLRN in human platelets. GPR310 treatment gave a highly significant 80% protection (P=0.0018) against ferric chloride-induced carotid artery injury in mice by extending occlusion time, without any effect on tail bleeding. PAR4-mediated dense granule secretion and calcium flux were both attenuated by GPR310. Consistent with these results, GPR310 inhibited 12(S)-HETE-mediated and PAR4-mediated Rap1-GTP and RASA3 translocation to the plasma membrane and attenuated PAR4-Akt and ERK activation. GPR310 caused a right shift in thrombin-mediated human platelet aggregation, comparable to the effects of inhibition of the Gi-coupled P2Y12 receptor. Co-immunoprecipitation studies revealed that GPR31 and PAR4 form a heterodimeric complex in recombinant systems. CONCLUSIONS The 12-LOX product 12(S)-HETE stimulates GPR31-Gi-signaling pathways, which enhance thrombin-PAR4 platelet activation and arterial thrombosis in human platelets and mouse models. Suppression of this bioactive lipid pathway, as exemplified by a GPR31 pepducin antagonist, may provide beneficial protective effects against platelet aggregation and arterial thrombosis with minimal effect on hemostasis.
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Affiliation(s)
- Layla Van Doren
- Division of Hematology/Oncology, Center for Hemostasis and Thrombosis Research, Tufts Medical Center, Boston, MA (L.V.D., N.N., C.G., E.K.F., R.S., L.C., A.K.)
| | - Nga Nguyen
- Division of Hematology/Oncology, Center for Hemostasis and Thrombosis Research, Tufts Medical Center, Boston, MA (L.V.D., N.N., C.G., E.K.F., R.S., L.C., A.K.)
| | - Christopher Garzia
- Division of Hematology/Oncology, Center for Hemostasis and Thrombosis Research, Tufts Medical Center, Boston, MA (L.V.D., N.N., C.G., E.K.F., R.S., L.C., A.K.)
| | - Elizabeth K Fletcher
- Division of Hematology/Oncology, Center for Hemostasis and Thrombosis Research, Tufts Medical Center, Boston, MA (L.V.D., N.N., C.G., E.K.F., R.S., L.C., A.K.)
| | - Ryan Stevenson
- Division of Hematology/Oncology, Center for Hemostasis and Thrombosis Research, Tufts Medical Center, Boston, MA (L.V.D., N.N., C.G., E.K.F., R.S., L.C., A.K.)
| | | | - Athan Kuliopulos
- Division of Hematology/Oncology, Center for Hemostasis and Thrombosis Research, Tufts Medical Center, Boston, MA (L.V.D., N.N., C.G., E.K.F., R.S., L.C., A.K.)
- Departments of Medicine (L.C., A.K.), Tufts University School of Medicine, Boston, MA
- Biochemistry (L.C., A.K.), Tufts University School of Medicine, Boston, MA
| | - Lidija Covic
- Division of Hematology/Oncology, Center for Hemostasis and Thrombosis Research, Tufts Medical Center, Boston, MA (L.V.D., N.N., C.G., E.K.F., R.S., L.C., A.K.)
- Departments of Medicine (L.C., A.K.), Tufts University School of Medicine, Boston, MA
- Biochemistry (L.C., A.K.), Tufts University School of Medicine, Boston, MA
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Han W, Wei Z, Dang R, Guo Y, Zhang H, Geng C, Wang C, Feng Q, Jiang P. Angiotensin-Ⅱ and angiotensin-(1-7) imbalance affects comorbidity of depression and coronary heart disease. Peptides 2020; 131:170353. [PMID: 32599080 DOI: 10.1016/j.peptides.2020.170353] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/19/2020] [Accepted: 06/23/2020] [Indexed: 01/03/2023]
Abstract
A large body of evidence suggests a relationship between depression and coronary heart disease (CHD). Angiotensin-Ⅱ (Ang-Ⅱ) and angiotensin-(1-7) [Ang-(1-7)] are considered to exert biological effects in both conditions. Here, we aimed to determine the role of Ang-Ⅱ and Ang-(1-7) in the occurrence of comorbid depression in patients with CHD. Our study included 214 CHD patients and 100 matched healthy controls. Serum Ang-Ⅱ and Ang-(1-7) levels were assessed by ELISA, and the depression symptoms were evaluated by the nine-item Patient Health Questionnaire (PHQ-9). Linear regression and correlation analyses were used to estimate the associations between PHQ-9 scores and Ang-Ⅱ and Ang-(1-7) serum levels. Six single-nucleotide polymorphisms (SNPs) spanning the angiotensin converting enzyme 2 (ACE2) and MAS1 genes were genotyped. The associations between SNPs and depression risk in CHD patients were examined using logistic regression analysis with adjustment for age and gender. Decreased Ang-(1-7) (P < 0.05) and an elevated Ang-Ⅱ/Ang-(1-7) ratio (P < 0.01) were observed in CHD patients with depression compared to CHD patients without depression. PHQ-9 scores were negatively correlated with Ang-(1-7) level (r=-0.44, P < 0.01) and positively correlated with the Ang-Ⅱ/Ang-(1-7) ratio (r = 0.33, P < 0.05). Furthermore, carriers of risk allele T for CHD with depression had significantly higher PHQ-9 scores (P < 0.05), lower Ang-(1-7) level (P < 0.01), and higher Ang-Ⅱ/Ang-(1-7) ratio (P < 0.05) than those CC carriers. Collectively, our results firstly showed that Ang-(1-7) serum level in CHD patients may protect against comorbid depression. Moreover, the imbalance between Ang-Ⅱ and Ang-(1-7) may contribute to depression in CHD patients.
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Affiliation(s)
- Wenxiu Han
- Jining First People's Hospital, Jining Medical University, Jining 272000, China
| | - Zhijie Wei
- Jining First People's Hospital, Jining Medical University, Jining 272000, China
| | - Ruili Dang
- Jining First People's Hospital, Jining Medical University, Jining 272000, China
| | - Yujin Guo
- Jining First People's Hospital, Jining Medical University, Jining 272000, China
| | - Hailiang Zhang
- Jining First People's Hospital, Jining Medical University, Jining 272000, China
| | - Chunmei Geng
- Jining First People's Hospital, Jining Medical University, Jining 272000, China
| | - Changshui Wang
- Department of Clinical & Translational Medicine, Jining Life Science Center, Jining 272000, China
| | - Qingyan Feng
- Jining First People's Hospital, Jining Medical University, Jining 272000, China.
| | - Pei Jiang
- Jining First People's Hospital, Jining Medical University, Jining 272000, China.
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Giri B, Belanger K, Seamon M, Bradley E, Purohit S, Chong R, Morgan JC, Baban B, Wakade C. Niacin Ameliorates Neuro-Inflammation in Parkinson's Disease via GPR109A. Int J Mol Sci 2019; 20:ijms20184559. [PMID: 31540057 PMCID: PMC6770365 DOI: 10.3390/ijms20184559] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [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: 08/14/2019] [Revised: 09/06/2019] [Accepted: 09/10/2019] [Indexed: 12/17/2022] Open
Abstract
In this study, we used macrophage RAW264.7 cells to elucidate the molecular mechanism underlying the anti-inflammatory actions of niacin. Anti-inflammatory actions of niacin and a possible role of its receptor GPR109A have been studied previously. However, the precise molecular mechanism of niacin’s action in reducing inflammation through GPR109A is unknown. Here we observed that niacin reduced the translocation of phosphorylated nuclear kappa B (p-NF-κB) induced by lipopolysaccharide (LPS) in the nucleus of RAW264.7 cells. The reduction in the nuclear translocation in turn decreased the expression of pro-inflammatory cytokines IL-1β, IL-6 in RAW264.7 cells. We observed a decrease in the nuclear translocation of p-NF-κB and the expression of inflammatory cytokines after knockdown of GPR109A in RAW264.7 cells. Our results suggest that these molecular actions of niacin are mediated via its receptor GPR109A (also known as HCAR2) by controlling the translocation of p-NF-κB to the nucleus. Overall, our findings suggest that niacin treatment may have potential in reducing inflammation by targeting GPR109A.
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Affiliation(s)
- Banabihari Giri
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA.
- Department of Physical Therapy, Augusta University, Augusta, GA 30912, USA.
| | - Kasey Belanger
- Department of Physiology, Augusta University, Augusta, GA 30912, USA.
| | - Marissa Seamon
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA.
- Department of Neuroscience, Augusta University, Augusta, GA 30912, USA.
| | - Eric Bradley
- Edward Via College of Osteopathic Medicine, Greenville, SC 29303, USA.
| | - Sharad Purohit
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA.
- Department of Undergraduate Health Professionals, Augusta University, Augusta, GA 30912, USA.
| | - Raymond Chong
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA.
- Department of Interdisciplinary Health Sciences, Augusta University, Augusta, GA 30912, USA.
| | - John C Morgan
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA.
- Department of Neurology, Augusta University, Augusta, GA 30912, USA.
| | - Babak Baban
- Department of Oral Biology and Diagnostic Sciences, Augusta University, Augusta, GA 30912, USA.
| | - Chandramohan Wakade
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA.
- Department of Physical Therapy, Augusta University, Augusta, GA 30912, USA.
- Department of Neuroscience, Augusta University, Augusta, GA 30912, USA.
- Department of Neurology, Augusta University, Augusta, GA 30912, USA.
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Miller-Gallacher J, Sanders P, Young S, Sullivan A, Baker S, Reddington SC, Clue M, Kabelis K, Clark J, Wilmot J, Thomas D, Chlebowska M, Cole F, Pearson E, Roberts E, Holly M, Evans M, Núñez Miguel R, Powell M, Sanders J, Furmaniak J, Rees Smith B. Crystal structure of a ligand-free stable TSH receptor leucine-rich repeat domain. J Mol Endocrinol 2019; 62:117-128. [PMID: 30689545 DOI: 10.1530/jme-18-0213] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 01/28/2019] [Indexed: 12/19/2022]
Abstract
The crystal structures of the thyroid-stimulating hormone receptor (TSHR) leucine-rich repeat domain (amino acids 22-260; TSHR260) in complex with a stimulating human monoclonal autoantibody (M22TM) and in complex with a blocking human autoantibody (K1-70™) have been solved. However, attempts to purify and crystallise free TSHR260, that is not bound to an autoantibody, have been unsuccessful due to the poor stability of free TSHR260. We now describe a TSHR260 mutant that has been stabilised by the introduction of six mutations (H63C, R112P, D143P, D151E, V169R and I253R) to form TSHR260-JMG55TM, which is approximately 900 times more thermostable than wild-type TSHR260. These six mutations did not affect the binding of human TSHR monoclonal autoantibodies or patient serum TSHR autoantibodies to the TSHR260. Furthermore, the response of full-length TSHR to stimulation by TSH or human TSHR monoclonal autoantibodies was not affected by the six mutations. Thermostable TSHR260-JMG55TM has been purified and crystallised without ligand and the structure solved at 2.83 Å resolution. This is the first reported structure of a glycoprotein hormone receptor crystallised without ligand. The unbound TSHR260-JMG55TM structure and the M22 and K1-70 bound TSHR260 structures are remarkably similar except for small changes in side chain conformations. This suggests that neither the mutations nor the binding of M22TM or K1-70TM change the rigid leucine-rich repeat domain structure of TSHR260. The solved TSHR260-JMG55TM structure provides a rationale as to why the six mutations have a thermostabilising effect and provides helpful guidelines for thermostabilisation strategies of other soluble protein domains.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jill Clark
- FIRS Laboratories, RSR Ltd, Cardiff, CF14 5DUUK
| | - Jane Wilmot
- FIRS Laboratories, RSR Ltd, Cardiff, CF14 5DUUK
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Abstract
Platelets are small anucleated cells that constantly patrol the cardiovascular system to preserve its integrity and prevent excessive blood loss where the vessel lining is breached. Their key challenge is to form a hemostatic plug under conditions of high shear forces. To do so, platelets have evolved a molecular machinery that enables them to sense trace amounts of signals at the site of damage and to rapidly shift from a non-adhesive to a pro-adhesive state. However, this highly efficient molecular machinery can also lead to unintended platelet activation and cause clinical complications such as thrombocytopenia and thrombosis. Thus, several checkpoints are in place to tightly control platelet activation and adhesiveness in space and time. In this review, we will discuss select negative regulators of platelet activation, which are critical to maintain patrolling platelets in a quiescent, non-adhesive state and/or to limit platelet adhesion to sites of injury.
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Affiliation(s)
- L Stefanini
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - W Bergmeier
- Department of Biochemistry and Biophysics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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10
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Muñoz-Sánchez MÁ, Rodríguez-Rodríguez A, Egea-Guerrero JJ, Gordillo-Escobar E, Vilches-Arenas Á, Carrillo-Vico A, Guerrero JM, Murillo-Cabezas F. Urotensinergic system genes in experimental subarachnoid hemorrhage. Med Intensiva 2017; 41:468-474. [PMID: 28081921 DOI: 10.1016/j.medin.2016.10.013] [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: 06/17/2016] [Revised: 10/14/2016] [Accepted: 10/23/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Cerebral vasospasm, one of the main complications of subarachnoid hemorrhage (SAH), is characterized by arterial constriction and mainly occurs from day 4 until the second week after the event. Urotensin-II (U-II) has been described as the most potent vasoconstrictor peptide in mammals. An analysis is made of the serum U-II concentrations and mRNA expression levels of U-II, urotensin related peptide (URP) and urotensin receptor (UT) genes in an experimental murine model of SAH. DESIGN An experimental study was carried out. SETTING Experimental operating room of the Biomedicine Institute of Seville (IBiS), Virgen del Rocío University Hospital (Seville, Spain). PARTICIPANTS 96 Wistar rats: 74 SAH and 22 sham intervention animals. INTERVENTIONS Day 1: blood sampling, followed by the percutaneous injection of 100μl saline (sham) or blood (SAH) into the subarachnoid space. Day 5: blood sampling, followed by sacrifice of the animals. MAIN VARIABLES OF INTEREST Weight, early mortality, serum U-II levels, mRNA values for U-II, URP and UT. RESULTS Serum U-II levels increased in the SAH group from day 1 (0.62pg/mL [IQR 0.36-1.08]) to day 5 (0.74pg/mL [IQR 0.39-1.43]) (p<0.05), though not in the sham group (0.56pg/mL [IQR 0.06-0.83] day 1; 0.37pg/mL [IQR 0.23-0.62] day 5; p=0.959). Between-group differences were found on day 5 (p<0.05). The ROC analysis showed that the day 5 serum U-II levels (AUC=0.691), URP mRNA (AUC=0.706) and UT mRNA (AUC=0.713) could discriminate between sham and SAH rats. The normal serum U-II concentration range in rats was 0.56pg/mL (IQR 0.06-0.83). CONCLUSION The urotensinergic system is upregulated on day 5 in an experimental model of SAH.
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MESH Headings
- Animals
- Biomarkers
- Disease Models, Animal
- Gene Expression Regulation
- Peptide Hormones/biosynthesis
- Peptide Hormones/blood
- Peptide Hormones/genetics
- RNA, Messenger/biosynthesis
- RNA, Messenger/blood
- RNA, Messenger/genetics
- ROC Curve
- Rats
- Rats, Wistar
- Real-Time Polymerase Chain Reaction
- Receptors, G-Protein-Coupled/biosynthesis
- Receptors, G-Protein-Coupled/blood
- Receptors, G-Protein-Coupled/genetics
- Sensitivity and Specificity
- Subarachnoid Hemorrhage/complications
- Subarachnoid Hemorrhage/genetics
- Urotensins/biosynthesis
- Urotensins/blood
- Urotensins/genetics
- Vasoconstriction/genetics
- Vasospasm, Intracranial/etiology
- Vasospasm, Intracranial/genetics
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Affiliation(s)
- M Á Muñoz-Sánchez
- Servicio de Urgencias, Hospital Universitario Virgen del Rocío, IBIS/CSIC/Universidad de Sevilla, Spain
| | - A Rodríguez-Rodríguez
- Cuidados Críticos, Hospital Universitario Virgen del Rocío, IBIS/CSIC/Universidad de Sevilla, Spain.
| | - J J Egea-Guerrero
- Cuidados Críticos, Hospital Universitario Virgen del Rocío, IBIS/CSIC/Universidad de Sevilla, Spain
| | - E Gordillo-Escobar
- Cuidados Críticos, Hospital Universitario Virgen del Rocío, IBIS/CSIC/Universidad de Sevilla, Spain
| | - Á Vilches-Arenas
- Servicio de Medicina Preventiva y Salud Pública, Hospital Virgen Macarena, Universidad de Sevilla, Spain
| | - A Carrillo-Vico
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Spain; Departamento de Bioquimica Médica, Biología molecular e Inmunología, Facultad de Medicina, Universidad de Sevilla, Spain
| | - J M Guerrero
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Spain; Departamento de Bioquimica Médica, Biología molecular e Inmunología, Facultad de Medicina, Universidad de Sevilla, Spain
| | - F Murillo-Cabezas
- Cuidados Críticos, Hospital Universitario Virgen del Rocío, IBIS/CSIC/Universidad de Sevilla, Spain
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Li L, Xu J, Chen L, Jiang Z. Apelin/APJ system: a novel promising therapy target for thrombotic diseases. Acta Biochim Biophys Sin (Shanghai) 2016; 48:589-91. [PMID: 27084519 DOI: 10.1093/abbs/gmw028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 03/14/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Lanfang Li
- Institute of Cardiovascular Disease, Key Laboratory for Arteriosclerology of Hunan Province, University of South China, Hengyang 421001, China Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Institute of Pharmacy and Pharmacology, Learning Key Laboratory for Pharmacoproteomics, University of South China, Hengyang 421001, China
| | - Jin Xu
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Institute of Pharmacy and Pharmacology, Learning Key Laboratory for Pharmacoproteomics, University of South China, Hengyang 421001, China
| | - Linxi Chen
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Institute of Pharmacy and Pharmacology, Learning Key Laboratory for Pharmacoproteomics, University of South China, Hengyang 421001, China
| | - Zhisheng Jiang
- Institute of Cardiovascular Disease, Key Laboratory for Arteriosclerology of Hunan Province, University of South China, Hengyang 421001, China
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12
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Demir B, Caglar IM, Tureli HO, Pirhan O, Aciksari G, Gedikbasi A, Zorkun C, Demir E, Karakaya O. Coronary slow flow phenomenon associated with high serum levels of soluble CD40 ligand and urotensin II: a multi-marker approach. Clin Lab 2015; 60:1909-20. [PMID: 25648034 DOI: 10.7754/clin.lab.2014.140316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the serum soluble CD40 ligand (sCD40L) levels, serum uroten- sin II levels, and serum leptin levels as an indirect indicator of endothelial dysfunction, inflammation, and atherosclerosis at the microvascular level, and the comparison of those values with those of the control group with a nor- mal coronary flow pattern. METHODS The study included 35 consecutive patients (17 women, 18 men; average age: 51.20 ± 10.93 years) in our hospital who underwent coronary angiography due to objective myocardial ischemia and in whom slow coronary flow was detected. The control group included 34 consecutive patients with normal coronary flow pattern (18 women, 16 men; average age: 54.59 ± 12.40 years). The coronary flow rates of all patients and control subjects were documented by the thrombolysis in myocardial infarction (TIMI) frame count. Serum sCD40L concentrations, serum urotensin II concentrations and serum leptin concentrations were measured by an enzyme-linked immunosorbent assay method using commercially available kits. RESULTS The corrected TIMI frame count for LAD, Cx, RCA, and mean TIMI frame count were significantly higher in patients with slow coronary flow (SCF), compared to subjects with normal coronary flow (43.8 ± 1.7 vs. 17.7 ± 4.7, p < 0.001; 27.9 ± 6.9 vs. 11.9 ± 4.8, p < 0.001; 25.4 ± 8.4 vs. 11.1 ± 3.1, p < 0.001; and 32.3 ± 6.4 vs. 13.7 ± 5, p < 0.001, respectively). The serum soluble CD40 ligand and serum urotensin II levels were significantly higher in the slow coronary flow group compared to the control group (12.00 ± 5.43 ng/mL--6.49 ± 5.03 ng/mL, p < 0.001; and 50.94 ± 34.28 pg/mL--26.91 ± 11.52 pg/mL, p < 0.001, respectively). In addition, there was no statistically significant difference between the slow coronary flow group and the control group with regard to serum leptin levels and hs-CRP levels (both p > 0.05). CONCLUSIONS This study suggests that soluble CD40 ligand and urotensin II likely play a role in the pathogenesis of slow coronary flow.
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Sonne DP, Rehfeld JF, Holst JJ, Vilsbøll T, Knop FK. Postprandial gallbladder emptying in patients with type 2 diabetes: potential implications for bile-induced secretion of glucagon-like peptide 1. Eur J Endocrinol 2014; 171:407-19. [PMID: 24986531 DOI: 10.1530/eje-14-0309] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Recent preclinical work has suggested that postprandial flow of bile acids into the small intestine potentiates nutrient-induced glucagon-like peptide 1 (GLP1(GCG)) secretion via bile acid-induced activation of the G protein-coupled receptor TGR5 in intestinal L cells. The notion of bile-induced GLP1 secretion combined with the findings of reduced postprandial gallbladder emptying in patients with type 2 diabetes (T2DM) led us to speculate whether reduced postprandial GLP1 responses in some patients with T2DM arise as a consequence of diabetic gallbladder dysmotility. DESIGN AND METHODS In a randomised design, 15 patients with long-standing T2DM and 15 healthy age-, gender- and BMI-matched control subjects were studied during 75-g oral glucose tolerance test (OGTT) and three isocaloric (500 kcal) and isovolaemic (350 ml) liquid meals: i) 2.5 g fat, 107 g carbohydrate and 13 g protein; ii) 10 g fat, 93 g carbohydrate and 11 g protein; and iii) 40 g fat, 32 g carbohydrate and 3 g protein. Basal and postprandial plasma concentrations of glucose, insulin, C-peptide, glucagon, GLP1, glucose-dependent insulinotropic polypeptide (GIP), cholecystokinin and gastrin were measured. Furthermore, gallbladder emptying and gastric emptying were examined. RESULTS Gallbladder emptying increased with increasing meal fat content, but no intergroup differences were demonstrated. GIP and GLP1 responses were comparable among the groups with GIP levels being higher following high-fat meals, whereas GLP1 secretion was similar after both OGTT and meals. CONCLUSIONS In conclusion, patients with T2DM exhibited normal gallbladder emptying to meals with a wide range of fat content. Incretin responses were similar to that in controls, and an association with postprandial gallbladder contraction could not be demonstrated.
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Affiliation(s)
- David P Sonne
- Diabetes Research DivisionDepartment of Medicine, Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, DK-2900 Hellerup, DenmarkThe NNF Center for Basic Metabolic ResearchDepartment of Biomedical Sciences, The Panum Institute, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical BiochemistryCopenhagen University Hospital Rigshospitalet, Copenhagen, Denmark Diabetes Research DivisionDepartment of Medicine, Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, DK-2900 Hellerup, DenmarkThe NNF Center for Basic Metabolic ResearchDepartment of Biomedical Sciences, The Panum Institute, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical BiochemistryCopenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Jens F Rehfeld
- Diabetes Research DivisionDepartment of Medicine, Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, DK-2900 Hellerup, DenmarkThe NNF Center for Basic Metabolic ResearchDepartment of Biomedical Sciences, The Panum Institute, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical BiochemistryCopenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Jens J Holst
- Diabetes Research DivisionDepartment of Medicine, Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, DK-2900 Hellerup, DenmarkThe NNF Center for Basic Metabolic ResearchDepartment of Biomedical Sciences, The Panum Institute, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical BiochemistryCopenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Tina Vilsbøll
- Diabetes Research DivisionDepartment of Medicine, Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, DK-2900 Hellerup, DenmarkThe NNF Center for Basic Metabolic ResearchDepartment of Biomedical Sciences, The Panum Institute, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical BiochemistryCopenhagen University Hospital Rigshospitalet, Copenhagen, Denmark Diabetes Research DivisionDepartment of Medicine, Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, DK-2900 Hellerup, DenmarkThe NNF Center for Basic Metabolic ResearchDepartment of Biomedical Sciences, The Panum Institute, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical BiochemistryCopenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Filip K Knop
- Diabetes Research DivisionDepartment of Medicine, Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, DK-2900 Hellerup, DenmarkThe NNF Center for Basic Metabolic ResearchDepartment of Biomedical Sciences, The Panum Institute, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical BiochemistryCopenhagen University Hospital Rigshospitalet, Copenhagen, Denmark Diabetes Research DivisionDepartment of Medicine, Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, DK-2900 Hellerup, DenmarkThe NNF Center for Basic Metabolic ResearchDepartment of Biomedical Sciences, The Panum Institute, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical BiochemistryCopenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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14
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Lu J, Jiang T, Wu L, Gao L, Wang Y, Zhou F, Zhang S, Zhang Y. The expression of angiotensin-converting enzyme 2-angiotensin-(1-7)-Mas receptor axis are upregulated after acute cerebral ischemic stroke in rats. Neuropeptides 2013; 47:289-95. [PMID: 24090950 DOI: 10.1016/j.npep.2013.09.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [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: 05/01/2013] [Revised: 08/10/2013] [Accepted: 09/09/2013] [Indexed: 01/23/2023]
Abstract
There is now unequivocal evidence that the angiotensin-converting enzyme 2(ACE2)-Ang-(1-7)-Mas axis is a key component of the renin-angiotensin system (RAS) cascade, which is closely correlated with ischemic insult occurrence. Our previous studies demonstrated that the Ang-(1-7), was an active member of the brain RAS. However, the ACE2-Ang-(1-7)-Mas axis expression after cerebral ischemic injury are currently unclear. In the present study, we investigated the time course of ACE2-Ang-(1-7) and Mas receptor expression in the acute stage of cerebral ischemic stroke. The content of Ang-(1-7) in ischemic tissues and blood serum was measured by specific EIA kits. Real-time PCR and western blot were used to determine messenger RNA (mRNA) and protein levels of the ACE2 and Mas. The cerebral ischemic lesion resulted in a significant increase of regional cerebral and circulating Ang-(1-7) at 6-48 h compared with sham operation group following focal ischemic stroke (12h: 7.276±0.320 ng/ml vs. 2.466±0.410 ng/ml, serum; 1.024±0.056 ng/mg vs. 0.499±0.032, brain) (P<0.05). Both ACE2 and Mas expression were markedly enhanced compared to the control in the ischemic tissues (P<0.05). Mas immunopositive neurons were also seen stronger expression in the ischemic cortex (19.167±2.858 vs. 7.833±2.483) (P<0.05). The evidence collected in our present study will indicate that, ACE2-Ang-(1-7)-Mas axis are upregulated after acute ischemic stroke and would play a pivotal role in the regulation of acute neuron injury in ischemic cerebrovascular diseases.
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Affiliation(s)
- Jie Lu
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China
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15
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Krist J, Wieder K, Klöting N, Oberbach A, Kralisch S, Wiesner T, Schön MR, Gärtner D, Dietrich A, Shang E, Lohmann T, Dreßler M, Fasshauer M, Stumvoll M, Blüher M. Effects of weight loss and exercise on apelin serum concentrations and adipose tissue expression in human obesity. Obes Facts 2013; 6:57-69. [PMID: 23429279 PMCID: PMC5644751 DOI: 10.1159/000348667] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 08/03/2012] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Apelin is an adipokine which plays a role in the regulation of glucose homeostasis and may contribute to the link between increased adipose tissue mass and obesity related metabolic diseases. Here we investigate the role of omental and subcutaneous (SC) adipose tissue apelin and its receptor APJ mRNA expression in human obesity and test the hypothesis that changes in circulating apelin are associated with reduced fat mass in three weight loss intervention studies. METHODS Apelin serum concentration was measured in 740 individuals in a cross-sectional (n = 629) study including a subgroup (n = 161) for which omental and SC apelin mRNA expression has been analyzed and in three interventions: 12 weeks exercise (n = 60), 6 months calorie-restricted diet (n = 19), 12 months after bariatric surgery (n = 32). RESULTS Apelin mRNA is significantly higher expressed in adipose tissue of patients with type 2 diabetes and correlates with circulating apelin, BMI, body fat, C-reactive protein, and insulin sensitivity. Obesity surgery-induced weight loss causes a significant reduction in omental and SC apelin expression. All interventions led to significantly reduced apelin serum concentrations which significantly correlate with improved insulin sensitivity, independently of changes in BMI. CONCLUSIONS Reduced apelin expression and serum concentration may contribute to improved insulin sensitivity beyond significant weight loss.
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Affiliation(s)
- Joanna Krist
- Department of Medicine, University of Leipzig, Junior Research Group Animal Models, Dresden, Germany
| | - Katharina Wieder
- Department of Medicine, University of Leipzig, Junior Research Group Animal Models, Dresden, Germany
| | - Nora Klöting
- Leipzig University Medical Center, IFB Adiposity Diseases, Junior Research Group Animal Models, Dresden, Germany
| | - Andreas Oberbach
- Department of Pediatric Surgery, University of Leipzig, Leipzig, Germany
| | - Susan Kralisch
- Department of Medicine, University of Leipzig, Junior Research Group Animal Models, Dresden, Germany
| | - Tobias Wiesner
- Department of Medicine, University of Leipzig, Junior Research Group Animal Models, Dresden, Germany
| | - Michael R. Schön
- Clinic of Visceral Surgery, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - Daniel Gärtner
- Clinic of Visceral Surgery, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - Arne Dietrich
- Department of Surgery, University of Leipzig, Dresden, Germany
| | - Edward Shang
- Department of Surgery, University of Leipzig, Dresden, Germany
| | | | | | - Mathias Fasshauer
- Department of Medicine, University of Leipzig, Junior Research Group Animal Models, Dresden, Germany
| | - Michael Stumvoll
- Department of Medicine, University of Leipzig, Junior Research Group Animal Models, Dresden, Germany
| | - Matthias Blüher
- Department of Medicine, University of Leipzig, Junior Research Group Animal Models, Dresden, Germany
- *Prof. Dr. med. Matthias Blüher, Department of Medicine, University of Leipzig, Liebigstraße 20, 04103 Leipzig (Germany),
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Valladares-Ayerbes M, Blanco-Calvo M, Reboredo M, Lorenzo-Patiño MJ, Iglesias-Díaz P, Haz M, Díaz-Prado S, Medina V, Santamarina I, Pértega S, Figueroa A, Antón-Aparicio LM. Evaluation of the adenocarcinoma-associated gene AGR2 and the intestinal stem cell marker LGR5 as biomarkers in colorectal cancer. Int J Mol Sci 2012; 13:4367-4387. [PMID: 22605983 PMCID: PMC3344219 DOI: 10.3390/ijms13044367] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 03/20/2012] [Accepted: 03/23/2012] [Indexed: 01/06/2023] Open
Abstract
We aim to estimate the diagnostic performances of anterior gradient homolog-2 (AGR2) and Leucine-rich repeat-containing-G-protein-coupled receptor 5 (LGR5) in peripheral blood (PB) as mRNA biomarkers in colorectal cancer (CRC) and to explore their prognostic significance. Real-time PCR was used to analyze AGR2 and LGR5 in 54 stages I-IV CRC patients and 19 controls. Both mRNAs were significantly increased in PB from CRC patients compared to controls. The area under the receiver-operating characteristic curves were 0.722 (p = 0.006), 0.376 (p = 0.123) and 0.767 (p = 0.001) for AGR2, LGR5 and combined AGR2/LGR5, respectively. The AGR2/LGR5 assay resulted in 67.4% sensitivity and 94.7% specificity. AGR2 correlated with pT3–pT4 and high-grade tumors. LGR5 correlated with metastasis, R2 resections and high-grade. The progression-free survival (PFS) of patients with high AGR2 was reduced (p = 0.037; HR, 2.32), also in the stage I-III subgroup (p = 0.046). LGR5 indicated a poor prognosis regarding both PFS (p = 0.007; HR, 1.013) and overall survival (p = 0.045; HR, 1.01). High AGR2/LGR5 was associated with poor PFS (p = 0.014; HR, 2.8) by multivariate analysis. Our findings indicate that the assessment of AGR2 and LGR5 in PB might reflect the presence of circulating tumor cells (CTC) and stem cell like CTC in CRC. Increased AGR2 and LGR5 are associated with poor outcomes.
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Affiliation(s)
- Manuel Valladares-Ayerbes
- Medical Oncology Department, La Coruña University Hospital, Servicio Galego de Saúde (SERGAS), As Xubias, 84. PC 15006, La Coruña, Spain; E-Mails: (M.R.); (L.M.A.-A.)
- Translational Cancer Research Lab, Biomedical Research Institute (INIBIC), Carretera del Pasaje, s/n. PC 15006, La Coruña, Spain; E-Mails: (M.B.-C.); (M.H.); (V.M.); (I.S.); (A.F.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel. +34-981178000 (ext. 292848); Fax: +34-981178273
| | - Moisés Blanco-Calvo
- Translational Cancer Research Lab, Biomedical Research Institute (INIBIC), Carretera del Pasaje, s/n. PC 15006, La Coruña, Spain; E-Mails: (M.B.-C.); (M.H.); (V.M.); (I.S.); (A.F.)
| | - Margarita Reboredo
- Medical Oncology Department, La Coruña University Hospital, Servicio Galego de Saúde (SERGAS), As Xubias, 84. PC 15006, La Coruña, Spain; E-Mails: (M.R.); (L.M.A.-A.)
| | - María J. Lorenzo-Patiño
- Pathology Department, La Coruña University Hospital, Servicio Galego de Saúde (SERGAS), As Xubias, 84. PC 15006, La Coruña, Spain; E-Mails: (M.J.L.-P.); (P.I.-D.)
| | - Pilar Iglesias-Díaz
- Pathology Department, La Coruña University Hospital, Servicio Galego de Saúde (SERGAS), As Xubias, 84. PC 15006, La Coruña, Spain; E-Mails: (M.J.L.-P.); (P.I.-D.)
| | - Mar Haz
- Translational Cancer Research Lab, Biomedical Research Institute (INIBIC), Carretera del Pasaje, s/n. PC 15006, La Coruña, Spain; E-Mails: (M.B.-C.); (M.H.); (V.M.); (I.S.); (A.F.)
| | - Silvia Díaz-Prado
- Tissue Engineering and Cellular Therapy Lab, INIBIC, Carretera del Pasaje, s/n. PC 15006, La Coruña, Spain; E-Mail:
- Medicine Department, La Coruña University (UDC), Campus de Oza, s/n, PC 15006, La Coruña, Spain
| | - Vanessa Medina
- Translational Cancer Research Lab, Biomedical Research Institute (INIBIC), Carretera del Pasaje, s/n. PC 15006, La Coruña, Spain; E-Mails: (M.B.-C.); (M.H.); (V.M.); (I.S.); (A.F.)
| | - Isabel Santamarina
- Translational Cancer Research Lab, Biomedical Research Institute (INIBIC), Carretera del Pasaje, s/n. PC 15006, La Coruña, Spain; E-Mails: (M.B.-C.); (M.H.); (V.M.); (I.S.); (A.F.)
| | - Sonia Pértega
- Biostatistics and Clinical Epidemiology Unit, La Coruña University Hospital, Servicio Galego de Saúde (SERGAS), As Xubias 84, PC 15006, La Coruña, Spain; E-Mail:
| | - Angélica Figueroa
- Translational Cancer Research Lab, Biomedical Research Institute (INIBIC), Carretera del Pasaje, s/n. PC 15006, La Coruña, Spain; E-Mails: (M.B.-C.); (M.H.); (V.M.); (I.S.); (A.F.)
| | - Luis M. Antón-Aparicio
- Medical Oncology Department, La Coruña University Hospital, Servicio Galego de Saúde (SERGAS), As Xubias, 84. PC 15006, La Coruña, Spain; E-Mails: (M.R.); (L.M.A.-A.)
- Medicine Department, La Coruña University (UDC), Campus de Oza, s/n, PC 15006, La Coruña, Spain
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Sidharta PN, Rave K, Heinemann L, Chiossi E, Krähenbühl S, Dingemanse J. Effect of the urotensin-II receptor antagonist palosuran on secretion of and sensitivity to insulin in patients with Type 2 diabetes mellitus. Br J Clin Pharmacol 2009; 68:502-10. [PMID: 19843053 PMCID: PMC2780275 DOI: 10.1111/j.1365-2125.2009.03480.x] [Citation(s) in RCA: 18] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2008] [Accepted: 05/22/2009] [Indexed: 01/04/2023] Open
Abstract
AIMS To investigate the effects of palosuran, a nonpeptidic, potent and selective antagonist of the urotensin-II receptor, on insulin and glucose regulation in 20 diet-treated patients with Type 2 diabetes mellitus in a double-blind, placebo-controlled, randomized, crossover, proof-of-concept study. METHODS After 4 weeks' oral treatment with 125 mg palosuran or placebo b.i.d.,effects on insulin secretion and sensitivity and blood glucose levels were assessed by means of a hyperglycaemic glucose clamp, meal tolerance test, homeostasis model assessment-insulin resistance score, and daily self-monitoring of blood glucose. Plasma concentrations of palosuran were determined for 12 h on the last day of intake. RESULTS Palosuran did not affect second-phase insulin response (primary end-point) during the hyperglycaemic glucose clamp in comparison with placebo [paired difference of -1.8 microU ml(-1), 95% confidence interval (CI) -7.8, 4.2]. Likewise, no effects of palosuran were detected on the first-phase insulin response, or on insulin secretion and blood glucose levels during the meal tolerance test or on homeostasis model assessment-insulin resistance score. No clinically significant effects on daily blood glucose profiles were observed during the study. Geometric mean C(max) and AUC(tau) (95% CI) and median t(max) (range) in this patient population were 180 ng ml(-1) (125, 260), 581 ng.h ml(-1) (422, 800) and 3.0 h (0.67, 4.3), respectively. CONCLUSIONS The results of this study indicate that antagonism of the urotensin-II system does not influence insulin secretion or sensitivity or daily blood glucose levels in diet-treated patients with Type 2 diabetes.
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Affiliation(s)
- Patricia N Sidharta
- Department of Clinical Pharmacology, Actelion Pharmaceuticals Ltd, CH-4123 Allschwil, Switzerland.
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Castan-Laurell I, Vítkova M, Daviaud D, Dray C, Kováciková M, Kovacova Z, Hejnova J, Stich V, Valet P. Effect of hypocaloric diet-induced weight loss in obese women on plasma apelin and adipose tissue expression of apelin and APJ. Eur J Endocrinol 2008; 158:905-10. [PMID: 18390990 PMCID: PMC2683032 DOI: 10.1530/eje-08-0039] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.0] [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] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Apelin is a novel adipokine acting on APJ receptor, regulated by insulin and tumor necrosis factor-alpha (TNF-alpha) in adipose tissue (AT). Plasma apelin levels are increased in obese hyperinsulinemic subjects. The aim was to investigate whether the hypocaloric diet associated with weight loss modifies the elevated plasma apelin levels and the expression of apelin and APJ receptor in AT in obese women. DESIGN AND METHODS Fasting plasma levels of apelin and TNF-alpha as well as mRNA levels of apelin and APJ in AT were measured before and after a 12-week hypocaloric weight-reducing diet in 20 obese women (body mass index (BMI) before diet 32.2+/-6.4 kg/m(2)). Twelve healthy women with a BMI of 20.7+/-0.6 kg/m(2) served as reference. RESULTS Plasma levels of apelin and TNF-alpha were higher in obese compared with lean controls. The hypocaloric diet resulted in a significant decrease of BMI to 29.8+/-6.3 kg/m(2), plasma insulin (8.16+/-0.73 to 6.58+/-0.66 mU/l), apelin (369+/-25 pg/ml to 257+/-12 pg/ml), TNF-alpha levels (0.66+/-0.04 pg/ml to 0.56+/-0.04 pg/ml), and AT mRNAs of apelin and APJ. In addition, changes in AT mRNA apelin were related to changes in AT mRNA APJ levels. CONCLUSION The hypocaloric diet associated with weight loss reduces the increased plasma and AT expression of apelin in obese women. This reduced apelin expression in AT could contribute to decreased circulating apelin levels.
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Affiliation(s)
- Isabelle Castan-Laurell
- Inserm, U858 Equipe 3, Institut de Médecine Moléculaire de Rangueil, BP84225, Toulouse F-31432 Cedex 4, France.
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Yasuda SI, Miyazaki T, Munechika K, Yamashita M, Ikeda Y, Kamizono A. Isolation of Zn2+ as an endogenous agonist of GPR39 from fetal bovine serum. J Recept Signal Transduct Res 2007; 27:235-46. [PMID: 17885920 DOI: 10.1080/10799890701506147] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [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: 10/22/2022]
Abstract
We attempted to determine natural agonists of GPR39 in fetal bovine serum (FBS). FBS was conditioned to extract peptides and fractionated by two types of HPLC. The activity of each fraction was monitored by intracellular calcium mobilization. Then the purified active ingredient was analyzed by inductively coupled plasma mass spectrometry. In this fashion, Zn2+ ion was identified as an agonist of GPR39, though no peptidergic molecules were found. The calcium-mobilizing activity of Zn2+ was not abolished by pertussis toxin but was by a phospholipase C (PLC) inhibitor, U73122, indicating that the activity of GPR39 is mediated through the Gqalpha -PLC pathway. In addition, Zn2+ also activated mouse and rat GPR39, showing that the function of GPR39 as a Zn2+ receptor is conserved across species. This study is the first exploration of GPR39 agonists in FBS and indicates that GPR39 functions as a Gq-coupled Zn2+-sensing receptor.
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Affiliation(s)
- Shin-ichiro Yasuda
- Pharmaceuticals Research Division, Mitsubishi Pharma Corporation, Yokohama, Japan.
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Kato M, Aoki T, Tamanaka M, Hattori H, Furuhama K. Investigation of post-weaning changes in immunological parameters in male rats. Toxicology 2007; 232:119-31. [PMID: 17267092 DOI: 10.1016/j.tox.2006.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2006] [Revised: 12/08/2006] [Accepted: 12/16/2006] [Indexed: 10/23/2022]
Abstract
Normal post-weaning changes in immunological parameters were investigated in male Crl:CD(SD) rats (n=7) for matching of ages with children (referential data). The animals received a single intravenous administration of keyhole limpet hemocyanin (KLH) 3mg/kg on day 1 and were euthanized on day 7 at 5, 7, 9, and 11 weeks of age. Furthermore, to investigate age-dependent differences in susceptibility to cyclophosphamide immunotoxicity, the animals were given oral cyclophosphamide 5mg/kgday from days 1 to 8 and intravenous KLH on day 3, and were euthanized on day 9 at the above ages. As a result, the post-weaning development pattern of a continuous increase until 9 weeks of age, followed by a mild decrease at 11 weeks of age, was commonly observed in white blood cell counts and all of its differential counts in peripheral blood, spleen weight, and total cell, CD3+, CD4+, CD8+ and CD45RA+ cell counts in the spleen. This pattern is similar to the development pattern of peripheral blood cell counts in infants, which mostly peaks at 6-12 months of age. Cyclophosphamide decreased almost all of peripheral blood cell counts and lymphocyte subset counts in the thymus and spleen at all ages, to similar degrees. However, decreases in serum anti-KLH IgM and IgG levels were greatest at 9 weeks of age. In conclusion, 9 (immunization at 8) weeks of age in rats was shown to be the most susceptible timing for cyclophosphamide immunotoxicity, likely corresponding to 6-12 months of age in infants.
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Affiliation(s)
- Michiyuki Kato
- Drug Safety Research Laboratory, Daiichi Pharmaceutical Co. Ltd., 1-16-13 Kita-Kasai, Tokyo, Japan.
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Morgan AJ, Guillen C, Symon FA, Huynh TT, Berry MA, Entwisle JJ, Briskin M, Pavord ID, Wardlaw AJ. Expression of CXCR6 and its ligand CXCL16 in the lung in health and disease. Clin Exp Allergy 2006; 35:1572-80. [PMID: 16393323 DOI: 10.1111/j.1365-2222.2005.02383.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Chemokine receptors (CR) play an important role in T cell migration, but their contribution to lung trafficking is unclear. OBJECTIVE We hypothesized that if a particular CR was involved in T cell homing its expression would be enriched on lung T cells compared with peripheral blood T cells (PBT). METHODS We have measured the CR expression on BAL T cells from patients with sarcoid, other interstitial lung diseases (ILD), asthma and healthy volunteers. RESULTS Of 14 CR studied in sarcoid, CXCR6 expression was the most markedly increased in the lung compared with the blood, a finding that was also seen in ILD patients. A striking although lesser increase was also seen in asthmatics and healthy controls. Analysis of expression of the CXCR6 ligand, CXCL16, by immunohistochemistry suggested that alveolar macrophages (AM) were the major source of CXCL16 in the lung. AM expressed mRNA for CXCL16 and released nanogram quantities after adhesion to plastic as shown by RT-PCR, Western blotting and ELISA. Bronchoalveolar lavage (BAL) fluid from all subjects contained large amounts of CXCL16. The full-length CXCL16 was the predominant isoform in AM lysates, supernatants and BAL. CONCLUSION This data suggests that CXCR6 and CXCL16 may play a role in T cell recruitment to the lung.
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MESH Headings
- Adult
- Asthma/immunology
- Biomarkers/analysis
- Blotting, Western
- Bronchoalveolar Lavage Fluid/chemistry
- Case-Control Studies
- Chemokine CXCL16
- Chemokines, CXC/analysis
- Chemokines, CXC/blood
- Chemokines, CXC/genetics
- Female
- Flow Cytometry
- Humans
- Immunohistochemistry/methods
- Lung/immunology
- Lung Diseases/immunology
- Lymphocyte Count
- Macrophages, Alveolar/immunology
- Male
- Pulmonary Fibrosis/immunology
- RNA, Messenger/analysis
- Receptors, CXCR6
- Receptors, Chemokine
- Receptors, Cytokine/analysis
- Receptors, Cytokine/blood
- Receptors, Cytokine/genetics
- Receptors, G-Protein-Coupled/analysis
- Receptors, G-Protein-Coupled/blood
- Receptors, G-Protein-Coupled/genetics
- Receptors, Scavenger/analysis
- Receptors, Scavenger/blood
- Receptors, Scavenger/genetics
- Receptors, Virus/analysis
- Receptors, Virus/blood
- Receptors, Virus/genetics
- Sarcoidosis/immunology
- T-Lymphocytes/chemistry
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Affiliation(s)
- A J Morgan
- Institute for Lung Health, Department of Infection, Immunity and Inflammation, Leicester University, Glenfield Hospital, Leicester, UK
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Abstract
Blood vessels are constantly exposed to hemodynamic forces in the form of cyclic stretch and shear stress due to the pulsatile nature of blood pressure and flow. Endothelial cells (ECs) are subjected to the shear stress resulting from blood flow and are able to convert mechanical stimuli into intracellular signals that affect cellular functions, e.g., proliferation, apoptosis, migration, permeability, and remodeling, as well as gene expression. The ECs use multiple sensing mechanisms to detect changes in mechanical forces, leading to the activation of signaling networks. The cytoskeleton provides a structural framework for the EC to transmit mechanical forces between its luminal, abluminal and junctional surfaces and its interior, including the cytoplasm, the nucleus, and focal adhesion sites. Endothelial cells also respond differently to different modes of shear forces, e.g., laminar, disturbed, or oscillatory flows. In vitro studies on cultured ECs in flow channels have been conducted to investigate the molecular mechanisms by which cells convert the mechanical input into biochemical events, which eventually lead to functional responses. The knowledge gained on mechano-transduction, with verifications under in vivo conditions, will advance our understanding of the physiological and pathological processes in vascular remodeling and adaptation in health and disease.
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Affiliation(s)
- Yi-Shuan J Li
- Department of Bioengineering, University of California, San Diego, La Jolla, 92093-0412, USA
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Liggett SB. Lymphocyte GRK levels as biomarkers in heart failureThe opinions expressed in this article are not necessarily those of the Editors of the European Heart Journal or of the European Society of Cardiology. Eur Heart J 2005; 26:1695-6. [PMID: 16055498 DOI: 10.1093/eurheartj/ehi355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Li JJ, Wang H, Qu F, Musial C, Tino JA, Robl JA, Slusarchyk D, Golla R, Seethala R, Dickinson K, Giupponi L, Grover G, Sleph P, Flynn N, Murphy BJ, Gordon D, Kung M, Stoffel R. Tetrahydroisoquinoline 1-carboxamides as growth hormone secretagogues. Bioorg Med Chem Lett 2005; 15:1799-802. [PMID: 15780609 DOI: 10.1016/j.bmcl.2005.02.040] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [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: 01/04/2005] [Revised: 02/10/2005] [Accepted: 02/14/2005] [Indexed: 11/18/2022]
Abstract
Several novel series of tetrahydroisoquinoline 1-carboxamides were prepared and shown to be potent growth hormone (GH) secretagogues. Among them, carbamate 12a-E2 displays excellent in vivo activity by increasing plasma GH 10-fold in an anesthetized IV rat model.
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Affiliation(s)
- James J Li
- Discovery Chemistry, Bristol-Myers Squibb Pharmaceutical Research Institute, PO Box 5400, Princeton, NJ 08543, USA
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Lee C, Xu DZ, Feketeova E, Kannan KB, Yun JK, Deitch EA, Fekete Z, Livingston DH, Hauser CJ. Attenuation of Shock-Induced Acute Lung Injury by Sphingosine Kinase Inhibition. ACTA ACUST UNITED AC 2004; 57:955-60. [PMID: 15580017 DOI: 10.1097/01.ta.0000149495.44582.76] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Prolonged elevations of cytosolic calcium concentrations ([Ca2+]i) are required for optimal neutrophil (PMN) activation responses to G-Protein coupled chemoattractants. We recently showed that the coupling of endosomal Ca2+ store depletion to more prolonged entry of external Ca2+ depends on cellular conversion of sphingosine to sphingosine 1-phosphate (S1P) by sphingosine kinase (SK). We therefore hypothesized that inhibition of SK might inhibit PMN activation and thus ameliorate lung injury after trauma and hemorrhagic shock (T/HS). METHODS Chemotaxis (CTX) of human PMN was studied using modified Boyden chambers in the presence or absence of the selective SK inhibitor, SKI-2. After determining the concentration of SKI-2 that inhibited human PMN CTX by 50% (IC50) we subjected rats to T/HS (laparotomy, hemorrhage to 30-40 mm Hg x 90 minutes, 3 hours resuscitation). We then studied rat PMN CD11b expression using flow cytometry and lung injury using the Evans Blue dye technique in the presence of IC50 doses of SKI-2 or vehicle given in pretreatment at laparotomy. RESULTS Human PMN CTX was suppressed slightly more than 50% by 40 micromol/L SKI-2 (233 +/- 20 vs 103 +/- 12 x 10(3) cells/well, p < 0.001). Rat PMN expression of CD11b after T/HS was decreased from 352 +/- 30 to 232 +/- 7 MFU (p < 0.001) in the presence 30 micromol/L SKI-2. Lung permeability to Evans Blue was decreased from 9.5 +/- 2 to 4.1 +/- 0.7% (p = 0.036.). SKI-2 did not cause hemodynamic instability or alter resuscitation requirements. CONCLUSION Modulation of PMN Ca entry via SK inhibition inhibits PMN CTX in vitro, and inhibits CD11b expression in vivo without major effects on hemodynamics. These cellular changes were associated with amelioration of lung injury in vivo in a rat model of T/HS. These findings suggest that SK inhibition allows modulation of inflammation via control of [Ca2+]i without the cardiovascular compromise expected with Ca2+ channel blockade. SK inhibition therefore appears to be an important novel candidate therapy for inflammatory organ injury after shock.
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Affiliation(s)
- Cindy Lee
- Department of Surgery, Division of Trauma,, University of Medicine and Dentistry of New Jersey Medical School, Newark, New Jersey, USA
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Abstract
This article briefly reviews (a) how platelets normally function and (b) the clinical approach to disorders of platelet numbers and function.
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Affiliation(s)
- Alan D Michelson
- Center for Platelet Function Studies, Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA 01655, USA.
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