Potent stimulation of blood flow in fingers of volunteers after local short-term treatment with low-frequency magnetic fields from a novel device.

A novel hand-held low-frequency magnetic stimulator (MagCell-SR) was tested for its ability to stimulate microcirculation in fingers of healthy volunteers. Blood flow during and after 5 minutes exposure was quantified using Laser Doppler Perfusion Imaging Technique. The device was positioned between the wrist and the dorsal part of the backhand. Because the increase in blood flow could be caused by a release of nitric oxide (NO) from the vascular endothelial cells we tested NO production with a fluorescence marker and quantified the measurements in cell cultures of human umbilical endothelial cells (HUVEC). Exposure increased blood flow significantly, persisted several minutes, and then disappeared gradually. In order to assess the effect of a static magnetic field, the measurements were also carried out with the device shutoff. Here, only a small increase in blood flow was noted. The application of the rotating MagCell-SR to the HUVEC cultures leads to a rapid onset and a significant increase of NO release after 15 minutes. Thus, frequencies between 4 and 12 Hz supplied by the device improve microcirculation significantly. Therefore, this device can be used in all clinical situations where an improvement of the microcirculation is useful like in chronic wound healing deficits.

Stimulation of adenosine A2b receptors blocks apoptosis in the non-infarcted myocardium even when administered after the onset of infarction.

OBJECTIVE: Chronic adenosine A2b receptor stimulation has been shown to prevent ventricular remodelling after myocardial infarction (MI). We hypothesized that this effect is due to the inhibition of cardiac myocyte apoptosis in the myocardium remote from the infarction. METHODS: Rats were subjected to MI by LAD ligation in situ. Some animals were pre-treated with the stable adenosine analogue 2-chloro-adenosine (CADO). After 24 h, pro- and anti-apoptotic signals (protein kinase C isoforms, p38, g proteins, Bcl-2/Bax ratio, Akt, Bad), and marker of apoptosis execution (caspase-3, TUNEL) were quantified in the remote myocardium. RESULTS: CADO prevented the occurrence of apoptosis in the remote myocardium of an infarcted heart. This effect occured not only when CADO was started before the onset of ischemia but also when it started 3 h after the infarction. The anti-apoptotic effect of CADO was blocked by simultaneous administration of the selective adenosine A2b receptor antagonist MRS1754 (1 mg/kg). The anti-apoptotic effect of CADO seems to be mediated by g(alphaq) and by the activation of survival kinases (Bad) and by inhibition of the pro-apoptotic PKC-delta/p38-MAPK-pathway. CONCLUSION: Chronic adenosine A2b receptor stimulation blocks cardiac myocyte apoptosis in the remote myocardium even when started after the onset of infarction. This may explain the anti-remodelling-effect of the A2b receptor stimulation after infarction.

Nitric oxide synthases are crucially involved in the development of the severe cardiomyopathy of caveolin-1 knockout mice.

Targeted ablation of caveolin-1 (cav-1) results in a severe cardiomyopathy. How the loss of cav-1 mediates these abnormalities is currently under investigation. Mounting evidence indicates that cav-1 acts as a negative regulator of endothelial nitric oxide synthase resulting in a constitutive hyperactivation of the nitric oxide (NO)-pathway in cav-1 knockout mice (cav-1 ko). In this context we hypothesized that disturbed NO signalling is implicated in these changes. To explore this question cav-1 ko were compared with knockout counterparts experiencing 2 month postnatal NO synthase inhibition by N(G)-nitro-l-arginine methyl ester (l-NAME) treatment. Chronic l-NAME treatment resulted in significant improvements in heart function and exercise capacity in cav-1 ko. Furthermore, we found evidence for an enhanced radical stress in hearts of cav-1 ko which was markedly reduced by l-NAME treatment. Collectively, these findings suggest that NO synthases play a crucial role in the evolution of heart failure evident in cav-1 ko.

Chelerythrine treatment influences the balance of pro- and anti-apoptotic signaling pathways in the remote myocardium after infarction.

OBJECTIVE: Apoptotic processes may be implicated in the molecular pathomechanisms of ventricular remodeling after myocardial infarction (MI). The modulation of apoptosis by pro- and anti-apoptotic pathways in the myocardium remote from the infarction, including its link to protein kinase C (PKC), was focus of the present study. METHODS: Rats were subjected to MI by LAD ligation in situ. Some animals were pretreated with the PKC inhibitor chelerythrine. After 1 h up to 28 days, pro- and anti-apoptotic signals (caspase-3, Bcl-2/Bax ratio, Akt, Bad), and marker of apoptosis execution (DNA laddering, TUNEL) were quantified in the myocardium remote from the infarction. RESULTS: Activation of caspase-3, a pro-apoptotic shift of the Bcl-2/Bax ratio, and DNA fragmentation were observed as early as 3 h after infarction and persisted up to 28 days. Akt- and Bad-phosphorylation was unchanged. Chelerythrine markedly reduced DNA fragmentation. Caspase-3 activation was unchanged. Surprisingly, Bad and Akt phosphorylation were highly increased (180% and 750% of control). CONCLUSION: Chelerythrine influences the balance of pro- and anti-apoptotic pathways in the remote myocardium after infarction, with an inhibition of proapoptotic and an activation of anti-apoptotic signals.

Protein kinase C in the human heart: differential regulation of the isoforms in aortic stenosis or dilated cardiomyopathy.

OBJECTIVES: Protein kinase C (PKC) is a central enzyme in the regulation of growth and hypertrophy. Little was known on PKC isoform regulation in human heart. Goal of this study was to characterize the isoforms of protein kinase C in human heart, their changes during ontogenesis, and their regulation in myocardial hypertrophy and heart failure. METHODS: In left ventricular and atrial samples from adults with end-stage dilated cardiomyopathy (DCM), from adults with severe aortic stenosis (AS), from small infants undergoing repair of ventricular septal defects, and from healthy organ donors (CO), activity of protein kinase C and the expression of its isozymes were examined. RESULTS: In the adult human heart, the isoforms PKC-alpha, PCK-beta, PKC-delta, PKC-epsilon, PKC-lambda/-iota, and PKC-zeta were detected both on protein and on mRNA level. All isozymes are subjected to downregulation during ontogenesis. No evidence, however, exists for an isoform shift from infancy to adulthood. DCM leads to a pronounced upregulation of PKC-beta. Severe left ventricular hypertrophy in AS, however, recruits a distinct isoform pattern, i.e., isoforms PKC-alpha, PKC-delta, PKC-epsilon, PKC-lambda/-iota, and PKC-zeta are upregulated, whereas PKC-beta is not changed under this condition. CONCLUSION: This work gives evidence for a differential recruitment of human PKC isoforms in various forms of myocardial hypertrophy and heart failure.

Chronic angiotensin II receptor blockade induces cardioprotection during ischemia by increased PKC-epsilon expression in the mouse heart.

INTRODUCTION: This study was performed to investigate the role of chronic pretreatment with angiotensin II type 1 receptor antagonists (ARB) and angiotensin converting enzyme inhibitors (ACE-I) in myocardial infarction (MI) and ischemic preconditioning (iPC). Little is known about molecular mechanisms of MI and iPC, especially about protein kinase C (PKC) isozyme levels induced by chronic pharmacologic pretreatment with ARB and ACE-I. To address one of the most important signal molecules in iPC, the PKC system was investigated in an ischemia/reperfusion model using isolated mouse hearts. METHODS: C57/BL6 mice were treated orally with candesartan cilexetil or ramipril for 2 weeks. Isolated perfused hearts were subjected to 60 minutes of left anterior descending occlusion and 30 minutes of reperfusion. IPC was performed by 3 cycles of 5 minutes of ischemia prior to the infarct ischemia. Infarct size was measured using the propidium iodide method, and PKC isoenzymes were detected by immunoblotting in the membrane and cytosolic fraction. RESULTS: In the control group, iPC reduced infarct size from 59.8 +/- 4.2% to 24.5 +/- 1.7%. ARB pretreatment itself reduced the infarct size significantly (38.1 +/- 3.0%) in hearts without iPC. This protection could neither be enhanced by additional iPC (40.3 +/- 3.4%) nor blocked by the AT2-receptor antagonist PD123.319 (40.7 +/- 3.7%). The ARB-induced cardio protection, however, was abolished by chelerythrine (5 micromol/L) (71.7 +/- 6.6%, n = 11, P < 0.001). Furthermore, PKC-epsilon (PKC-epsilon) was significantly increased in the particulate fraction of ARB-pretreated mice. On the contrary, chronic treatment with ACE-I completely blocked iPC (57.7 +/- 3.9%, n = 12, P < 0.001) without any effect on infarct size itself (51.5 +/- 3.0%, n = 12). PKC-epsilon expression was significantly reduced. CONCLUSION: Chronic AT1-receptor antagonism is capable of protecting the heart against myocardial infarction in a PKC-epsilon-dependent way. Furthermore, chronic treatment with ACE-I is suggested to have suppressing effects on iPC, possibly caused by reduced PKC-epsilon expression.

Dual mechanism of autoregulation of protein kinase C in myocardial ischemia.

BACKGROUND: Recently, a dual activation mechanism of protein kinase C (PKC) in ischemia has been reported, consisting of early translocation and late expressional regulation. Moreover, autophosphorylation of the enzyme has been shown in vitro during its activation. This study aimed to show modes of late activation of PKC in myocardial ischemia in intact hearts. METHODS AND RESULTS: Isolated perfused hearts of male Wistar rats were used. A: To examine if the early translocation of PKC influences the late transcriptional activation, hearts were treated with the PKC-inhibitor Bisindolylmaleimid (BIS, 0.25 microM) before the onset of ischemia and then subjected to ischemia (30 min). PKC-isoform mRNA was quantified by RT-PCR. In these experiments, ischemia leads to a selective increase of mRNA specific for the isoforms PKC-delta and PKC-epsilon (163% and 168% of control, p<0.05). This ischemia-induced upregulation could be completely blocked by BIS given before the onset of ischemia. B: To test the capacity of PKC to undergo phosphorylation during ischemia, hearts were perfused with [32P]-phosphorus and then subjected to ischemia. Ischemia (30 min) induced a significant 3-fold increase of PKC phosphorylation. Stimulation of heart with the PKC-activator tetradecanoylphorbol-13-acetate (TPA) lead to a comparable phosphorylation, suggesting that ischemia leads to autophosphorylation of PKC. CONCLUSION: Ischemia activates two distinct forms of autoregulation of PKC. The expressional upregulation of PKC-delta and PKC-epsilon is dependent on early activation of the enzyme. At the same time, processes of enzyme phosphorylation occur. Both the mechanisms may contribute to enzyme activation processes beyond the classical enzyme translocation.

Comparative morphometric and immunohistological assessment of the development of restenosis after arterial injury and a cholesterol-rich diet in apolipoprotein E -/-mice and C57BL/6 control mice.

OBJECTIVE: Animal models of restenosis have been a cornerstone of testing potential therapies and have improved the understanding of the underlying mechanisms. The aim of this study was to provide an in-depth comparison of the progression of restenotic lesion formation after arterial injury in apolipoprotein E -/- and C57BL/6 control mice. METHODS: In this study, we investigated the difference in lesion formation of apolipoprotein E -/- and C57BL/6 controls on a high-cholesterol, high-fat diet after arterial injury. One week prior to arterial injury of the left femoral artery, mice were started on a high-cholesterol, high-fat diet. Diets were continued after arterial injury until euthanization. At five consecutive time points (2, 5, 10, 15, and 21 days), the intimal hyperplasia in the injured arteries was analyzed. RESULTS: In the C57BL/6 control mice, a continuously increasing lesion formation, consisting primarily of alpha-smooth muscle actin-positive cells, was observed. Lesion formation in apolipoprotein E -/- mice was significantly more pronounced, resulting in complete occlusion of the arteries in four out of five vessels after 21 days. Lesions in apolipoprotein E -/- mice consisted predominantly of lipid-loaded foam cells and alpha-smooth muscle actin-positive cells. Further histological evaluation demonstrated cholesterol crystals in the lesions and neovascularizsation in cases of occlusion. CONCLUSIONS: Thus, apoE -/- mice on a high-cholesterol, high-fat diet provide a more valid model for the characterization of the development of restenotic lesions after mechanical irritation such as angioplasty than C57BL/6 mice.

Transregulation of the alpha2-adrenergic signal transduction pathway by chronic beta-blockade: a novel mechanism for decreased platelet aggregation in patients.

Platelets play a pivotal role in the pathophysiology of acute coronary syndromes. Chronic beta-blockade has been shown to improve the long-term clinical outcome in coronary heart disease. Because platelets play a central role in thrombus formation, the aim of the present study was to investigate if chronic beta-blockade may transregulate the expression of alpha2-adrenergic receptors on human platelets and via this mechanism may modulate platelet activation. The densities of alpha2-adrenergic receptors of platelets were determined in healthy volunteers under chronic beta-blockade and as alpha2-adrenergic receptor-mediated function in catecholamine-induced platelet aggregation was determined. Chronic beta-blockade induced a time-dependent reduction of alpha2-adrenergic receptors. This reduction was accompanied by a decrease of the alpha-subunit of Gi proteins as demonstrated by Western blot analysis. This transregulation at both the receptor level and the G-protein level resulted in an almost complete loss of the alpha2-adrenergic receptor-mediated inhibition of adenylyl cyclase. The impairment of the alpha2-adrenergic receptor system correlated with a reduction of the catecholamine-induced activation and aggregation of human platelets. The functional transregulation of alpha2-adrenergic receptors by chronic beta-blockade in platelets and the consequent impairment of platelet activation may contribute to the therapeutic success of beta-blocker therapy.

The expression of macrophage migration inhibitory factor 1alpha (MIF 1alpha) in human atherosclerotic plaques is induced by different proatherogenic stimuli and associated with plaque instability.

OBJECTIVES: Macrophage migration inhibitory factor 1alpha (MIF), a cytokine with immunoregulatory functions has been suggested to be involved in atherosclerotic plaque development. However, little is known about MIF-inducing conditions in the atherosclerotic process and the association of MIF with plaque instability. METHODS AND RESULTS: Forty-two carotid endatherectomy samples from 36 patients and 4 aortic samples from young accident victims (as healthy controls) were analyzed for MIF staining. MIF expressing tissues in the atherosclerotic plaques are mainly mononuclear cells (MNCs), but also endothelial cells of intimal microvessels (MVECs). The magnitude and the intensity of their MIF expression was associated with the progression of plaques from early lesions (Stary I-III) to complicated plaque stages (Stary IV-VIII). In highly inflammatory and neovascularized regions of the plaques the colocalization of MIF expressing MNCs with CD40-L+ and angiotensin II (Ang II)-producing MNCs could be established. This finding supports the notion that CD40-L fusion protein and Ang II are able to induce MIF production in the monocytic cell line THP-1. Furthermore hypoxia (< or =1% O2) as a further proinflammatory and especially proangiogenetic factor was able to stimulate MIF secretion by THP-1, human monocytes and HUVECs. Hyperglycemia and insulin remained without effect. CONCLUSION: MIF is expressed in advanced atherosclerotic lesions in close correlation with signs of instability, such as mononuclear cell inflammation and neointimal microvessel formation. Furthermore, the colocalization of MIF with Ang II-producing MNCs and CD40-L+ cells in these plaques and the finding that proathero- and -angiogenic mediators such as CD40-L, Ang II and hypoxia are able to stimulate MIF expression in vitro suggest an important role of MIF in the modulation of atherosclerotic plaque stability.

A novel activation process of protein kinase C in the remote, non-ischemic area of an infarcted heart is mediated by angiotensin-AT1 receptors.

BACKGROUND: Translocation and activation of protein kinase C (PKC) has been shown to occur in the ischemic heart. It is, however, controversial if this activation process occurs also in the non-ischemic, remote area of an infarcted heart early after infarction. Furthermore, the mechanisms contributing to the translocation process induced by acute myocardial ischemia in both areas are not fully elucidated. METHODS: Regional myocardial infarction was induced by left anterior descending coronary artery (LAD-) ligation in situ for 2.5 min in rats or in pigs. To evaluate the influence of angiotensin and bradykinin signaling, ramiprilat, candesartan, or the bradykinin-receptor antagonist HOE 140 was given. In biopsies from the ischemic and the non-ischemic remote area, PKC activity and intracellular isozyme distribution were determined. RESULTS: Translocation and activation of PKC could be demonstrated for the first time in the myocardium remote from the infarcted area. This activation was conserved both in pigs and in rats. All major cardiac isozymes of PKC were involved. Whereas bradykinin-receptor blockade had no effect, both angiotensin-converting enzyme inhibition (ACEI) and angiotensin receptor could effectively block this activation process of PKC. CONCLUSION: In the area remote from a myocardial infarction, the activation of PKC could be detected for the first time as early as 2.5 min after LAD ligation. This newly characterized activation in the non-infarcted area can be prevented by ACEI via an angiotensin-AT1-receptor-dependent mechanism. It is supposed that this newly characterized activation process of PKC plays an important role in the signal transduction in the remote myocardium in acute myocardial infarction as a trigger for the late development of hypertrophy and heart failure.