脂联素与心血管疾病

脂联素（adiponectin）是一种具有胰岛素增敏作用的脂肪因子。近年来的研究发现,脂联素及其受体与心血管系统有广泛而密切的联系。脂联素影响心肌、平滑肌及内皮细胞功能,参与心肌肥大、心力衰竭、动脉粥样硬化、高血压及血管新生等病理生理过程。脂联素可能是代谢综合征和心血管事件的一个重要生物标志及治疗靶分子。     

促食欲素及其受体系统与神经系统疾病

促食欲素(orexin)作为一种神经肽在神经系统内分布广泛。促食欲素通过与其受体1及受体2结合引起下游信号通路激活,进而参与到摄食调节。近年来研究指出,促食欲素及其受体系统也参与睡眠-觉醒、学习记忆等机体重要生理过程,以及多种神经系统疾病的病理过程中。本文综述了促食欲素及其受体系统的生理及病理功能的最新研究进展,并揭示其与神经系统疾病发生和发展的相关性,为今后相关疾病的诊断和治疗提供理论基础。     

P-选择素及其细胞黏附与血栓形成

P-选择素是选择素家族的重要黏附分子,作为血小板/内皮细胞活化标志和细胞黏附受体,其可通过介导血小板、内皮细胞黏附及与白细胞的相互作用,启动参与了包括炎症和血栓形成等多种病理生理起始过程,是炎症/血栓的重要介质和靶分子。抑制P-选择素及其与配体的结合和作用,可使病理状态下血栓局部白细胞聚集减少、细胞因子及组织因子表达降低、纤维蛋白生成减少,从而有助于抑制血栓的形成。因此,随着P-选择素及其细胞黏附与血栓形成研究的不断深入和阐明,以P-选择素为靶标的血栓性疾病的诊断和抗黏附治疗,也已引起人们关注并具有良好的临床应用价值和前景。     

蛋白质来源活性多肽与心血管保护的新进展

心血管活性多肽是一种重要的生物活性多肽,研究发现了一系列活性多肽对心血管系统的自稳态调节起到非常重要的作用,包括中介素(IMD)、Apelin、胃饥饿素(Ghrelin)、胰高血糖素样肽(GLP1)、成纤维细胞生长因子(FGF21)等。这些活性多肽组织分布广泛,分子量小,免疫原性低,合成和代谢过程迅速,分泌后以配体与受体作用形式,通过细胞内多种信号通路调节心血管生理和病理生理过程,例如,血管的舒缩和新生、心脏缺血损伤后糖脂代谢及心肌重塑过程等。本文将对我们所研究的中介素以及其它几种重要的具有心血管保护作用的活性多肽及其在心血管发病中意义的研究进展做一综述。     

血管紧张素转换酶2的功能和应用

人血管紧张素转换酶2（ACE2）是肾素-血管紧张素系统（RAS）的重要调节分子,它在控制心血管和血压的正常生理活动中具有重要的作用。此外,ACE2作为SARS病毒的受体,对于病毒的入侵起关键作用。目前ACE2已经被用于高血压和心血管相关疾病的药物靶标设计和基因治疗,随着研究的深入,ACE2在临床上的应用将更加广泛。     

乳酸作为信号分子作用的研究进展

在既往研究中乳酸常被认为是糖酵解代谢废物,尤其被认为是肌肉疲劳的罪魁祸首。然而,越来越多的研究表明,乳酸在多种细胞生理与病理过程中扮演重要角色。乳酸不但可以作为能量来源参与机体脑神经元、心脏以及骨骼肌等组织细胞供能,而且还可作为一种特殊的信号分子借助其运输载体单羧酸转运体和特异性受体G蛋白偶联受体81在能量调节、肿瘤细胞生长转移和免疫逃逸、神经元能量代谢、突触可塑性、学习记忆和神经发育、细胞增殖分化等多种细胞生理病理过程中发挥重要调节作用。在此,该文就乳酸转运、信号转导及其在相关细胞生理病理过程中的重要生理作用进行综述,希望为深入理解乳酸的生物学特性及基础应用提供新的参考依据。     

蛋白酶活化受体2与心血管炎症反应

蛋白酶活化受体2为一类G蛋白偶联受体,广泛分布于心血管以及富含血管的组织器官,氨基末端被丝氨酸蛋白酶水解.新末端能激活受体自身,启动细胞内信号转导,从而参与不同组织器官的多种生理及病理生理过程,包括炎症、血管发生、疼痛与修复等.本文综述了该受体介导的心血管炎症反应方面的作用.     

内源性生物活性肽在血管钙化中的作用

血管钙化是诸如高血压、动脉粥样硬化、糖尿病及慢性肾功能衰竭等疾病的共同病理生理基础和重要危险因素之一,其发病机制尚不明确。近年来,心血管系统分泌的内源性生物活性肽在血管钙化的发生发展中发挥的作用受到越来越多的重视。然而,内源性活性多肽及其受体在血管钙化中一般作用规律和个体化调控特征尚需进一步探讨。因此,本文综述内源性生物活性肽,如皮质抑素、血管紧张素1-7、Aplin和瘦素等,在血管钙化中的作用及新进展,有助于揭示血管钙化的发病机制,从而为血管钙化的防治提供更多理论支持和思路。     

内源性心血管活性多肽与心房颤动

心房颤动也称房颤(atrial fibrillation,AF)是临床最常见的心律失常之一,随着年龄的增长房颤发病率逐年提高。房颤时心房丧失有效的收缩,导致患者心脏搏出量减少、心肌供血不足、快速心室率和心肌不规则收缩等,可导致心脏扩大、心房重塑和血栓形成,具有较高的致死率和致残率。心血管旁/自分泌的活性多肽通过多种机制参与心血管系统疾病如心力衰竭、心肌梗死、冠心病、高血压和心肌病的进程等。国内外研究已经证实多种心血管活性肽参与房颤的病理生理过程,其中一些活性肽是房颤发病的独立危险因素或者与房颤的治疗效果密切相关。本文结合国内外研究进展,对心房钠尿肽、B型钠尿肽、内皮缩血管肽、Apelin、UrotensinⅡ、松弛素、中介素等心血管活性多肽与房颤的联系进行简要综述。     

大麻素受体在胃肠运动调节中的作用

七次跨膜G蛋白偶联的大麻素受体至少有CB1和CB2两种亚型.尽管两种CB受体在胃肠道的分布不尽相同,但多数分布于肠神经系统.CB1受体激活可通过神经机制抑制瞬时下食管括约肌松弛,抑制小肠收缩和蠕动,减慢胃肠运动.CB2可能与一些特殊病理生理条件下胃肠运动的调节有关.这些结果提示CB特别是CB1受体在胃肠运动调节中的作用.     

Effect of relaxin on myocardial ischemia injury induced by isoproterenol

The omnipresent 6-kDa polypeptide relaxin (RLX) is emerging as a multifunctional endocrine and paracrine factor in a broad range of target tissues including cardiovascular tissues. To explore the pathophysiological roles of RLX in ischemic cardiovascular diseases, we studied the changes in RLX mRNA level in the myocardium and the effect of RLX supplements in rats with isoproterenol (ISO)-induced myocardial injury. In ISO-treated rats, RLX levels in myocardia and plasma increased 3.7- and 6.9-fold, respectively (P<0.01), the mRNA level increased significantly in myocardia compared with controls. Co-administration of RLX (0.2 and 2.0 microg/kg/d) and ISO increased left-ventricular pressure development and decreased left ventricular end-diastolic pressure (LVDEP) (all P<0.01). Malondialdehyde content in myocardia and lactate dehydrogenase and creatine phosphokinase activities in plasma in RLX-treated rats decreased markedly compared with that in ISO-treated alone rats (P<0.01 or P<0.05). In the high-dose RLX group, fibroblastic hyperplasia was relieved in myocardia, hydroxyproline level was lower, by 33% (P<0.05), and endothelin content in plasma was lower, by 31% (P<0.01) than in the ISO-alone group. Compared with control group, any indexes in sham rats treated with high-dose RLX were unaltered (all P>0.05). These results showed an up-regulation of myocardial RLX during ISO-induced myocardial ischemia injury and the protective effect of RLX on ISO-induced cardiac inhibition and fibrosis, which suggests that RLX could be an endogenous cardioprotective factor in ischemic heart diseases.     

Protection from cigarette smoke‐induced vascular injury by recombinant human relaxin‐2 (serelaxin)

Smoking is regarded as a major risk factor for the development of cardiovascular diseases (CVD). This study investigates whether serelaxin (RLX, recombinant human relaxin‐2) endowed with promising therapeutic properties in CVD, can be credited of a protective effect against cigarette smoke (CS)‐induced vascular damage and dysfunction. Guinea pigs exposed daily to CS for 8 weeks were treated with vehicle or RLX, delivered by osmotic pumps at daily doses of 1 or 10 μg. Controls were non‐smoking animals. Other studies were performed on primary guinea pig aortic endothelial (GPAE) cells, challenged with CS extracts (CSE) in the absence and presence of 100 ng/ml (17 nmol/l) RLX. In aortic specimens from CS‐exposed guinea pigs, both the contractile and the relaxant responses to phenylephrine and acetylcholine, respectively, were significantly reduced in amplitude and delayed, in keeping with the observed adverse remodelling of the aortic wall, endothelial injury and endothelial nitric oxide synthase (eNOS) down‐regulation. RLX at both doses maintained the aortic contractile and relaxant responses to a control‐like pattern and counteracted aortic wall remodelling and endothelial derangement. The experiments with GPAE cells showed that CSE significantly decreased cell viability and eNOS expression and promoted apoptosis by sparkling oxygen free radical‐related cytotoxicity, while RLX counterbalanced the adverse effects of CSE. These findings demonstrate that RLX is capable of counteracting CS‐mediated vascular damage and dysfunction by reducing oxidative stress, thus adding a tile to the growing mosaic of the beneficial effects of RLX in CVD.     

Paracrine effects of transplanted myoblasts and relaxin on post-infarction heart remodelling

In the post-infarcted heart, grafting of precursor cells may partially restore heart function but the improvement is modest and the mechanisms involved remain to be elucidated. Here, we explored this issue by transplanting C2C12 myoblasts, genetically engineered to express enhanced green fluorescent protein (eGFP) or eGFP and the cardiotropic hormone relaxin (RLX) through coronary venous route to swine with experimental chronic myocardial infarction. The rationale was to deliver constant, biologically effective levels of RLX at the site of cell engraftment. One month after engraftment, histological analysis showed that C2C12 myoblasts selectively settled in the ischaemic scar and were located around blood vessels showing an activated endothelium (ICAM-1-,VCAM-positive). C2C12 myoblasts did not trans-differentiate towards a cardiac phenotype, but did induce extracellular matrix remodelling by the secretion of matrix metalloproteases (MMP) and increase microvessel density through the expression of vascular endothelial growth factor (VEGF). Relaxin-producing C2C12 myoblasts displayed greater efficacy to engraft the post-ischaemic scar and to induce extracellular matrix re-modelling and angiogenesis as compared with the control cells. By echocardiography, C2C12-engrafted swine showed improved heart contractility compared with the ungrafted controls, especially those producing RLX. We suggest that the beneficial effects of myoblast grafting on cardiac function are primarily dependent on the paracrine effects of transplanted cells on extracellular matrix remodelling and vascularization. The combined treatment with myoblast transplantation and local RLX production may be helpful in preventing deleterious cardiac remodelling and may hold therapeutic possibility for post-infarcted patients.     

Estrogen in cardiovascular disease

PURPOSE OF REVIEW: The controversy surrounding hormone replacement therapy has induced fear in patients and left many researchers with the impression that estrogen produces negative effects on cardiovascular function. The aim of this review is to summarize recent findings illustrating that estrogen also has positive effects even if estrogen replacement therapy is not a cure-all. RECENT FINDINGS: Studies have unveiled new aspects of estrogen action in the cardiovascular system; however, clinical trials have not demonstrated a protective effect of the most widely used modalities of hormone replacement therapy against cardiovascular disease. New information has emerged showing that estrogen has both beneficial and detrimental effects. Further mechanistic studies and use of well defined forms of estrogens and selective estrogen receptor modulators will continue to provide novel mechanistic information that will likely lead to the development of new avenues for therapeutic interventions. SUMMARY: Estrogens, like other steroid hormones, are potent actors in the cardiovascular system. Since half the population have high levels of estrogen most of their lives it is plain that estrogen has a variety of beneficial physiologic functions. Clinical studies, however, have demonstrated that a specific formulation of a combination of potent estrogens and metabolites is not a magic bullet, but induces both positive and negative impacts on different organ systems. More research into the mechanistic actions of estrogens in specific pathways in individual cell types is necessary to determine appropriate therapeutic interventions to replace the loss of positive effects of estrogens while minimizing the negative effects in postmenopausal women.     

An optimized chemical synthesis of human relaxin‐2

Human gene 2 relaxin (RLX) is a member of the insulin superfamily and is a multi‐functional factor playing a vital role in pregnancy, aging, fibrosis, cardioprotection, vasodilation, inflammation, and angiogenesis. RLX is currently applied in clinical trials to cure among others acute heart failure, fibrosis, and preeclampsia. The synthesis of RLX by chemical methods is difficult because of the insolubility of its B‐chain and the required laborious and low yielding site‐directed combination of its A (RLXA) and B (RLXB) chains. We report here that oxidation of the Met²⁵ residue of RLXB improves its solubility, allowing its effective solid‐phase synthesis and application in random interchain combination reactions with RLXA. Linear Met(O)²⁵‐RLX B‐chain (RLXBO) reacts with a mixture of isomers of bicyclic A‐chain (bcRLXA) giving exclusively the native interchain combination. Applying this method Met(O)²⁵‐RLX (RLXO) was obtained in 62% yield and was easily converted to RLX in 78% yield, by reduction with ammonium iodide. Copyright © 2010 European Peptide Society and John Wiley & Sons, Ltd.     

Effects of tilting and volume loading on plasma levels and urinary excretion of relaxin, NT-pro-ANP, and NT-pro-BNP in male volunteers.

The polypeptide relaxin (RLX) has been suggested to play a role in cardiorenal integration and to be related to the natriuretic peptide system. We hence examined the effects of variations in thoracic blood volume and intravenous volume loading on plasma and urinary RLX levels and associated changes in natriuretic peptide levels in healthy men. Two groups of eight subjects were randomly tilted into a 15 degrees feet-down or a 15 degrees head-down position. Ten volunteers were crossover subjected to an infusion of 15 ml/kg of 0.9% NaCl (over 60 min) or control during an observation period of 10 h. Blood and urine were sampled at timed intervals. RLX, NH(2)-terminal prohormones of atrial natriuretic peptide (NT-pro-ANP), and NH(2)-terminal prohormones of brain natriuretic peptide (NT-pro-BNP) were determined by enzyme, radio-, and electrochemoluminescence immunoassays, respectively. NT-pro-ANP levels (in percentage of baseline levels) were higher (P < 0.05) during the head-down (124 +/- 13%) than during the feet-down position (82 +/- 6%). NT-pro-BNP and RLX were not affected by tilting. Volume loading induced a short-lasting increase in plasma NT-pro-ANP, a delayed increase in plasma NT-pro-BNP, had no effect on plasma RLX, and induced a parallel increase in urine flow, renal excretion of sodium, RLX, and NT-pro-BNP. It is concluded that variations in thoracic blood volume in healthy men are not associated with variations in plasma RLX. Increased urinary RLX and NT-pro-BNP excretion during volume loading suggest renal production and a possible role of kidney-derived RLX and brain natriuretic peptide in sodium homeostasis in men.     

Partial adenosine A1 receptor agonists for cardiovascular therapies

Adenosine, a purine nucleoside, is present in all cells in tightly regulated concentrations. It has many different physiological effects in the whole body and in the heart. Adenosine activates four G protein-coupled receptors A1, A2a, A2b, and A3. Activation of myocardial A1 receptors has been shown to inhibit a variety of myocardial pathologies associated with ischemia and reperfusion injury, including stunning, arrhythmogenesis, coronary and ventricular dysfunction, acute myocardial infarction, apoptosis, and chronic heart failure, implying several options for new cardiovascular therapies for diseases, like angina pectoris, control of cardiac rhythm, ischemic injury during an acute coronary syndrome, or heart failure. However, the main issue of using full A1 receptor agonists in such indications is the broad physiologic spectrum of cardiac and extracardiac effects. Desired A1 receptor-mediated protective and regenerative cardiovascular effects might be counter-regulated by unintended side effects when considering full A1 receptor agonists. These effects can be overcome by partial A1 agonists. Partial A1 agonists can be used to trigger only some of the physiological responses of receptor activation depending on endogenous adenosine levels and on receptor reserve in different tissues. CV-Therapeutics reported the identification of a partial A1 receptor agonist CVT-3619, and recently, another partial A1 receptor agonist VCP28 was published. Both compounds are adenosine derivatives. Adenosine-like A1 receptor agonists often have the drawback of a short half-life and low bioavailability, making them not suitable for chronic oral therapy. We identified the first non-adenosine-like partial A1 receptor agonist(s) with pharmacokinetics optimal for oral once daily treatment and characterized the qualities of the partial character of the A1 receptor agonist(s) in preclinical and clinical studies.

     

The effect of relaxin on the oxytocin receptor in human uterine smooth muscle cells

Experimental objectives: Activation of the oxytocin receptor (OTR) induces phospholipase C induced PIP(2) turnover in the human uterus. Relaxin (RLX), a polypeptide hormone produced in the corpus luteum of pregnancy as well as in the placenta and decidua inhibits PIP(2) turnover and subsequent signaling in human myometrium. The purpose of this study was to evaluate a possible effect of RLX on OTR regulation in human uterine smooth muscle cells. Primary cultures of myometrium from term pregnant women undergoing elective caesarean section were incubated for different time periods (0-96 h) and with different concentrations of RLX [10 pg/ml-20 microg/ml]. The effects on OTR binding, mRNA and protein expression were evaluated by means of (125)I-OVT binding assay, RT-PCR and flow cytometry. RESULTS: Prolonged RLX incubation was able to inhibit 30-40% of OTR binding while binding affinity remained unchanged. Oxytocin receptor mRNA and protein expression were down regulated by RLX about 50% and 35% respectively. CONCLUSION: We report for the first time an effect of RLX on OTR regulation in human uterine myometrial cells. The above results indicate that high local uterine RLX concentrations may be involved in uterine quiescence during human pregnancy by down regulating the OTR.     

Resting Sinus Heart Rate and First Degree AV block: Modifiable Risk Predictors or Epiphenomena?

Simple and cost-effective tools that identify patients at increased risk for adverse cardiovascular events are actively sought. High resting sinus heart rate and first degree AV block are easily recognized and commonly encountered findings in a cardiology practice. A growing body of epidemiological and clinical evidence has been shown them to be independent predictors of all-cause and cardiovascular mortality, both in the general population and in patients with structural heart disease. This paper reviews the important role of heart rate and first degree AV block in predicting cardiovascular outcomes, examines the pathophysiological mechanisms underlying this increased risk, and discusses the effectiveness of available therapies to favorably modify these risk factors.