BACKGROUND:Cardiac lymphangiogenesis has been proposed as a potential therapeutic target to prevent the development of heart failure. However, the efficiency of systemically delivered VEGFC (vascular endothelial growth factor C) protein in inducing cardiac lymphangiogenesis has shown inconsistency across different studies. Moreover, the mechanisms underlying lymphatic remodeling during heart failure remain poorly understood. METHODS:To determine the role of lymphatic remodeling in heart failure, we used adeno-associated virus-mediated gene therapy to either inhibit VEGFR3 (vascular endothelial growth factor receptor 3) expression or enhance VEGFC expression in mice subjected to transverse aortic constriction. In vitro studies were further conducted to investigate the role of Yes-associated protein in VEGFC/VEGFR3 signaling in lymphatic endothelial cells. RESULTS:Our study shows that transverse aortic constriction induces dynamic lymphatic remodeling, characterized by an early adaptive cardiac lymphangiogenic response and enhanced peripheral lymphatic transport function. Adeno-associated virus-sh-VEGFR3 treatment inhibited this early adaptive lymphangiogenesis, exacerbating cardiac inflammation and adverse remodeling. Conversely, adeno-associated virus-VEGFC therapy appeared to be cardioprotective by promoting adaptive lymphangiogenesis and facilitating the resolution of cardiac inflammation. Moreover, adeno-associated virus-VEGFC treatment improved peripheral lymphatic drainage function, potentially alleviating peripheral congestion in heart failure. Further in vivo and in vitro analyses revealed that Yes-associated protein dephosphorylation is essential for VEGFC/VEGFR3 signaling-dependent lymphangiogenesis and for upregulation of lymphatic chemokines and scavenger receptors. CONCLUSIONS:These findings highlight that targeting cardiac lymphangiogenesis via VEGFC/VEGFR3 signaling through genetic approaches represents a promising therapeutic strategy for heart failure. Moreover, VEGFC administration may offer a novel, noninvasive decongestive approach by modulating the lymphatic system in heart failure management.

Background: Several clinical studies have suggested that the early administration of statins could reduce the risk of in-hospital mortality in acute myocardial infarction (AMI) patients. Recently, some studies have identified that stimulating lymphangiogenesis after AMI could improve cardiac function by reducing myocardial edema and inflammation. This study aimed to identify the effect of rosuvastatin on postinfarct lymphangiogenesis and to identify the underlying mechanism of this effect. Method: Myocardial infarction (MI) was induced by ligation of the left anterior descending coronary artery in mice orally administered rosuvastatin for 7 days. The changes in cardiac function, pathology, and lymphangiogenesis following MI were measured by echocardiography and immunostaining. EdU, Matrigel tube formation, and scratch wound assays were used to evaluate the effect of rosuvastatin on the proliferation, tube formation, and migration of the lymphatic endothelial cell line SVEC4-10. The expression of miR-107-3p, miR-491-5p, and VEGFR3 was measured by polymerase chain reaction (PCR) and Western blotting. A gain-of-function study was performed using miR-107-3p and miR-491-5p mimics. Results: The rosuvastatin-treated mice had a significantly improved ejection fraction and increased lymphatic plexus density 7 days after MI. Rosuvastatin also reduced myocardial edema and inflammatory response after MI. We used a VEGFR3 inhibitor to partially reverse these effects. Rosuvastatin promoted the proliferation, migration, and tube formation of SVEC4-10 cells. PCR and Western blot analyses revealed that rosuvastatin intervention downregulated miR-107-3p and miR-491-5p and promoted VEGFR3 expression. The gain-of-function study showed that miR-107-3p and miR-491-5p could inhibit the proliferation, migration, and tube formation of SVEC4-10 cells. Conclusion: Rosuvastatin could improve heart function by promoting lymphangiogenesis after MI by regulating the miRNAs/VEGFR3 pathway.

In recent years, the function of the lymphatic system in atherosclerosis has attracted attention due to its role in immune cell trafficking, cholesterol removal from the periphery, and regulation of the inflammatory response. However, knowledge of the mechanisms regulating lymphangiogenesis and lymphatic function in the pathogenesis of atherosclerosis is limited. Endothelial microparticles carrying circulating microRNA (miRNA)s are known to mediate cell–cell communication, and our previous research showed that miRNA-19b in EMPs (EMPmiR-19b) was significantly increased in circulation and atherosclerotic vessels, and this increase in EMPmiR-19b promoted atherosclerosis. The present study investigated whether atherogenic EMPmiR-19b influences pathological changes of the lymphatic system in atherosclerosis. We first verified increased miR-19b levels and loss of lymphatic system function in atherosclerotic mice. Atherogenic western diet-fed ApoE-/- mice were injected with phosphate-buffered saline, EMPs carrying control miRNA (EMPcontrol), or EMPmiR-19b intravenously. The function and distribution of the lymphatic system was assessed via confocal microscopy, Evans blue staining, and pathological analysis. The results showed that lymphatic system dysfunction existed in the early stage of atherosclerosis, and the observed pathological changes persisted at the later stage, companied by an increased microRNA-19b level. In ApoE-/- mice systemically treated with EMPmiR-19b, the distribution, transport function, and permeability of the lymphatic system were significantly inhibited. In vitro experiments showed that miRNA-19b may damage the lymphatic system by inhibiting lymphatic endothelial cell migration and tube formation, and a possible mechanism is the inhibition of transforming growth factor beta receptor type II (TGF-βRII) expression in lymphatic endothelial cells by miRNA-19b. Together, our findings demonstrate that atherogenic EMPmiR-19b may destroy lymphatic system function in atherosclerotic mice by downregulating TGF-βRII expression.

To explore the potential targets underlying the effect of rosuvastatin on heart failure (HF) by utilizing a network pharmacology approach and experiments to identify the results. PharmMapper and other databases were mined for information relevant to the prediction of rosuvastatin targets and HF-related targets. Then, the rosuvastatin-HF target gene networks were created in Cytoscape software. Eventually, the targets and enriched pathways were examined by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Furthermore, we constructed an HF animal model and used rosuvastatin to treat them, identifying the changes in heart function and related protein expression. We further used different cells to explore the mechanisms of rosuvastatin. Thirty-five intersection targets indicated the therapeutic targets linked to HF. GO analysis showed that 481 biological processes, 4 cellular components and 23 molecular functions were identified. KEGG analysis showed 13 significant treatment pathways. In animal experiments, rosuvastatin significantly improved the cardiac function of post-myocardial infarction mice and prevented the development of HF after myocardial infarction by inhibiting IL-1Β expression. Cell experiments showed that rosuvastatin could reduce the expression of IL-1B in HUVEC and THP-1 cells. The therapeutic mechanism of rosuvastatin against HF may be closely related to the inhibition of the expression of apoptosis-related proteins, inflammatory factors, and fibrosis-related genes. However, IL-1Β is one of the most important target genes.

(Pro)renin receptor (PRR) and Yes-associated protein (YAP) play an important role in cardiovascular diseases. However, the role of PRR–YAP pathway in the pathogenesis of DCM is also not clear. We hypothesized that PRR–YAP pathway may promote pathological injuries in DCM by triggering redox. Wistar rats and neonatal rat cardiac fibroblasts were respectively used in vivo and in vitro studies. In order to observe the effects of PRR mediated YAP pathway on the pathogenesis of DCM, animal experiments were divided into 3 parts, including the evaluation the effects of PRR overexpression, PRR RNAi silencing and YAP RNAi silencing. Recombinant-adenoviruses-carried-PRR-gene (Ad-PRR), Ad-PRR-shRNA and lentivirus-carried-YAP-shRNA were constructed and the effects of PRR mediated YAP on the pathogenesis of DCM were evaluated. YAP specific inhibitor Verteporfin was also administrated in cardiac fibroblasts to explore the impact of PRR–YAP pathway on oxidative stress and myocardial fibrosis. The results displayed that PRR overexpression could enhance YAP expression but PRR RNAi silencing down-regulated its expression. Moreover, PRR overexpression could exacerbate oxidative stress and myocardial fibrosis in DCM, and these pathological changes could be rescued by YAP blockade. We concluded that PRR–YAP pathway plays a key role in the pathogenesis of DCM.

Diabetic cardiomyopathy (DCM) is a common complication associated with diabetes. The (pro)renin receptor (PRR) is an important member of the local tissue renin-angiotensin system and plays a vital role in many cardiovascular diseases. Yes-associated protein (YAP) also plays a crucial role in many cardiovascular diseases. However, the mechanism responsible for the effects of PRR and YAP on DCM remains unclear. The purpose of this study was to determine the role of PRR in the pathological progression of DCM and whether PRR influences the pathological processes of diabetic cardiomyopathy through YAP. We first established diabetic cardiomyopathy rats model, downregulated the expression of PRR, and upregulated and downregulated the expression of YAP. The levels of myocardial inflammation and fibrosis were then measured and cardiac function was evaluated. In vitro, primary rat cardiac fibroblasts (CFs) were cultured with high glucose, with or without transfection with recombinant adenovirus expressing PRR, and GSK621 was used to observe the effect of AMPK. The levels of inflammation and fibrosis were measured in vitro. The results showed that PRR and YAP silencing alleviated myocardial inflammation and fibrosis. GSK621 blocked the effect of PRR on AMPK and YAP and improved CF inflammation and fibrosis. The inhibition of PRR expression offers a new therapeutic strategy for the treatment of DCM. The effects of PRR on the pathological process of DCM in rats may be mediated via the PRR-AMPK-YAP pathway.

目的 系统性评价巨噬细胞移动抑制因子(MIF)基因启动子区-173多态性与冠状动脉粥样硬化性心脏病(CAD)发病风险之间的关系.方法 计算机检索中英文数据库,收集CAD与MIF基因启动子区-173多态性的病例对照研究.依据纳入标准和排除标准提取数据.Stata16.0软件进行系统分析.结果 共有10个研究被纳入meta分析.结果 显示,在4种遗传模型下,MIF基因启动子区-173位点单核苷酸多态性(SNP)与CAD发病风险具有相关性(等位基因模型OR=1.39;隐性基因模型OR=1.82;显性基因模型OR=1.43;纯合子基因模型OR=1.98),且该位点SNP中携带等位基因C是CAD的危险因素.亚组分析提示对于亚洲人群及非亚洲人群,该位点的SNP均与CAD发病风险相关.结论 本研究发现MIF基因启动子区-173多态性与CAD发病风险明显相关,且该位点SNP中携带等位基因C是CAD的危险因素.

In our clinical practice, we recently found some patients with severe fulminant myocarditis (FM) who showed persistently elevated cardiac troponin (cTn) levels and "seemingly normal" B-type natriuretic peptide (BNP) level, and who subsequently progressed to poor outcomes. Indeed, this sounds contrary to conventional wisdom, but it is not an accidental phenomenon. Fulminant myocarditis is a rapidly progressive disease associated with high mortality. Recent studies have shown that patients with FM are significantly more likely to require heart transplantation than those without FM. Prompt diagnosis of FM and the institution of advanced cardiac life support will save more lives. Cardiac troponin and BNP are widely used diagnostic markers. Cardiac troponin is a specific marker of cardiac injury and its level correlates with the severity of cardiac injury. However, plasma BNP has a dual identity; it is not only a marker of cardiac pressure/volume overload, but it is also a cardioprotective factor that provides effective neurohormonal compensation to maintain homeostasis. Similar to fulminant hepatitis (characterised by diffuse inflammation and massive parenchymal cell necrosis) sometimes showing disproportion between transaminase level and bilirubin level, the disproportion between cTn and BNP levels in FM seems to be consistent with its severe histopathological changes, including diffuse infiltration of the myocardium by inflammatory cells, as well as severe cardiomyocyte injury and necrosis. Moreover, in previous studies, a lower BNP level was found to be an adverse prognostic marker in end-stage heart failure. All these findings indicate that in patients with FM with a persistently high cTn level and ominous clinical presentation, a "seemingly normal" BNP level is not a friendly signal. We hypothesise that the combination of a persistently elevated cTn level and low BNP level in patients with FM indicates worse myocardial injury and poor prognosis.

To perform a comprehensive meta-analysis of all available evidence on the efficacy and safety of catheter-based renal denervation for heart failure with reduced ejection fraction. We searched English and Chinese databases and calculated the weighted mean difference or standardized mean difference and 95% confidence intervals to estimate the efficacy and safety of renal denervation for heart failure. All relevant studies were screened and a meta-analysis was conducted using Review Manager 5.4. A total of 11 studies were identified for the meta-analysis. For the primary outcomes, the results showed that renal denervation significantly improved ejection fraction (weighted mean difference 6.42), left ventricular end-systolic diameter (weighted mean difference −3.95), left ventricular end-diastolic diameter (weighted mean difference −4.17) and left atrial diameter (weighted mean difference −4.09). For the secondary outcomes, renal denervation reduced the B-type natriuretic peptide level, heart rate, systolic blood pressure and diastolic blood pressure. However, further analysis revealed that renal denervation improved heart function but did not further reduce the heart rate and blood pressure compared with the control group. Treatment with renal denervation can significantly improve heart function and structure in patients with heart failure. In addition, the level of B-type natriuretic peptide can be reduced after renal denervation treatment. Renal denervation did not further reduce heart rate and blood pressure compared with the control group. Therefore, the treatment of heart failure with renal denervation is effective and safe.

(Pro)renin receptor (PRR) is a novel component of the renin-angiotensin system that has been demonstrated to be involved in cardiovascular diseases. Recent research reported that diabetic cardiomyopathy (DCM) may be accompanied by high expression of PRR, indicating that PRR may be a potential therapeutic target for DCM. However, the exact mechanisms of PRR in DCM have not been completely clarified. This study hypothesized that PRR is involved in the pathological progression of DCM and can exacerbate myocardial fibrosis and cardiac dysfunction. Inhibition of PRR expression may alleviate these pathological changes. In this study, in vivo experiments were performed in Wistar rats, and in vitro experiments were carried out in rat cardiac fibroblasts. After establishing an in vivo DCM model, the rats were divided into a control group, DCM group, adenovirus scrambled short hairpin RNA group, and adenovirus PRR short hairpin RNA group to observe further the effects of PRR RNA interference (RNAi) silencing on the pathogenesis of DCM. The results showed that PRR RNAi silencing decreased myocardial fibrosis and improved cardiac function in DCM. The study also observed the effects of PRR RNAi silencing on high glucose stimulated cardiac fibroblasts, and the results showed that PRR RNAi silencing inhibited the expression of type I collagen, type III collagen, and transforming growth factor beta. It was concluded that PRR plays a key role in the pathological progression of DCM and that inhibition of PRR expression achieved by specific PRR RNAi silencing offers a new therapeutic approach for DCM. The underlying mechanisms of these effects may be associated with the ERK signaling pathway and oxidative stress.

Alcoholic cardiomyopathy (ACM) caused by alcohol consumption manifests mainly as by maladaptive myocardial function, which eventually leads to heart failure and causes serious public health problems. The (pro)renin receptor (PRR) is an important member of the local tissue renin-angiotensin system and plays a vital role in many cardiovascular diseases. However, the mechanism responsible for the effects of PRR on ACM remains unclear. The purpose of this study was to determine the role of PRR in myocardial fibrosis and the deterioration of cardiac function in alcoholic cardiomyopathy. Wistar rats were fed a liquid diet containing 9% v/v alcohol to establish an alcoholic cardiomyopathy model. Eight weeks later, rats were injected with 1×109v.g./100 μl of recombinant adenovirus containing EGFP (scramble-shRNA), PRR, and PRR-shRNA via the tail vein. Cardiac function was assessed by echocardiography. Cardiac histopathology was measured by Masson’s trichrome staining, immunohistochemical staining, and dihydroethidium staining. In addition, cardiac fibroblasts (CFs) were cultured to evaluate the effects of alcohol stimulation on the production of the extracellular matrix and their underlying mechanisms. Our results indicated that overexpression of PRR in rats with alcoholic cardiomyopathy exacerbates myocardial oxidative stress and myocardial fibrosis. Silencing of PRR expression with short hairpin RNA (shRNA) technology reversed the myocardial damage mediated by PRR. Additionally, PRR activated phosphorylation of ERK1/2 and increased NOX4-derived reactive oxygen species and collagen expression in CFs with alcohol stimulation. Administration of the ERK kinase inhibitor (PD98059) significantly reduced NOX4 protein expression and collagen production, which indicated that PRR increases collagen production primarily through the PRR-ERK1/2-NOX4 pathway in CFs. In conclusion, our study demonstrated that PRR induces myocardial fibrosis and deteriorates cardiac function through ROS from the PRR-ERK1/2-NOX4 pathway during ACM development.

Excessive activation of the renin-angiotensin system (RAS) in diabetic cardiomyopathy (DCM) provokes a series of structural and functional abnormalities, and causes ventricular remodeling and heart failure in diabetes. (Pro)renin receptor (PRR) is a component of the RAS and has been reported to be up-regulated in some cardiovascular diseases. Furthermore, PRR blockade in some cardiovascular diseases, such as myocardial infarction and hypertension, has been demonstrated to reverse their pathogenesis. However, there have been few studies about the function of PRR in the pathogenesis of DCM. In this study, we hypothesized that PRR is involved in the pathogenesis of DCM and mediates myocardial injury in DCM. To explore the role of PRR in DCM, we evaluated the effects of PRR overexpression and knockdown on the DCM phenotype in vivo and in vitro. The results show that PRR overexpression exacerbates myocardial injury and the inflammatory response in rats with DCM. Conversely, PRR knockdown alleviates myocardial fibrosis, apoptosis, and the inflammatory response, reversing the cardiac dysfunction in rats with DCM. In cell experiments, PRR overexpression also up-regulated the protein expression of collagen I and fibronectin, aggravated the inflammatory response, and increased the production of reactive oxygen species, whereas PRR knockdown had the opposite effect. Thus, PRR mediates myocardial injury, apoptosis, and the inflammatory response, likely through a PRR/extracellular signal-regulated kinase/reactive oxygen species pathway.

Background (Pro)renin receptor (PRR), a novel member of the renin–angiotensin system, participates in various cardiovascular diseases. However, the role of PRR in alcoholic cardiomyopathy ( ACM ), which is caused by alcohol intake and manifests as myocardial damage and cardiac dysfunction, remains unclear. Methods PRR gene silencing was achieved by transfecting recombinant adenovirus expressing anti‐ PRR short hairpin RNA ( PRR ‐sh RNA ). In vitro, primary rat cardiac fibroblasts ( CF s) were cultured with the stimulation of alcohol (200 mM), with or without PRR ‐sh RNA and PD 98059. Immunofluorescence, RT ‐ PCR , and Western blot were used to measure the protein and messenger ( mRNA ) expression of PRR , fibrotic factors, and members of related signaling pathways. In vivo, Wistar rats were fed a diet containing 9% (v/v) alcohol or a normal diet for 3 months, with or without PRR ‐sh RNA . Sirius Red staining, immunohistochemical staining, and toluidine blue staining were used to evaluate myocardial fibrosis, oxidative stress, and inflammation response. Results Alcohol markedly increased PRR mRNA and protein expression in a time‐ and concentration‐dependent manner in CF s. The increased expression of fibrotic factors induced by alcohol was prevented by PRR ‐sh RNA and PD 98059. Moreover, PRR ‐sh RNA decreased the phosphorylation of extracellular regulated protein kinases (ERK) 1/2 in CF s. Furthermore, PRR ‐sh RNA decreased cardiac fibrosis, reduced oxidative stress, and alleviated inflammation response in the myocardial tissue. Conclusions Our results show that PRR ‐ ERK 1/2 signaling was involved in the development of ACM and that PRR could be a new target for the treatment of ACM.

目的 研究携带血管紧张素转换酶2(ACE2)基因的重组腺病毒载体(Ad-ACE2)转染对高脂饲养的载脂蛋白E基因敲除(ApoE-/-)小鼠保护内皮、改善胰岛素抵抗及抑制肝脏纤维化的影响.方法 用高脂高能量饲料喂养ApoE-/-小鼠,模拟代谢综合征.30只ApoE-/-小鼠随机分为对照组(Con组)、ACE2基因对照组(EGFP组)和ACE2基因治疗组(ACE2组),每组10只,均给予高脂饮食.3组分别通过尾静脉注射生理盐水、Ad-EGFP和Ad-ACE2干预.12周末行葡萄糖耐量试验和胰岛素耐量试验.小鼠麻醉后,心尖取血,测定血脂水平.取肝脏组织进行HE染色、油红0染色.免疫组织化学染色观察肝组织ACE2、Ⅰ型胶原蛋白(COL-Ⅰ)、Ⅲ型胶原蛋白(COL-Ⅲ)、白细胞介素6(IL-6)表达.结果 用Ad-ACE2转染的ACE2组显著提高了ApoE-/-小鼠肝脏中ACE2的表达(P＜0.05),ACE2组内皮依赖性功能明显优于Con组和EGFP组(P＜0.05),胰岛素敏感性强于Con组和EGFP组(P＜0.05),而血脂水平无明显改变.ACE2组肝脏组织中COL-Ⅰ、COL-Ⅲ、IL-6表达均低于Con组和EGFP组(P＜0.05).结论 ACE2过表达能够保护内皮,改善胰岛素抵抗,抑制肝脏纤维化,从而保护肝脏功能.

AIM:To observed the protective effect of diminazene aceturate(DIZE),an angiotensin-converting enzyme 2(ACE2)activator,on rats with diabetic cardiomyopathy(DCM).METHODS:Male Wistar rats(n=30)were randomly divided into normal control group ,DCM group and DIZE treatment group(DIZE group).The rats in DCM group and DIZE group were intraperitoneally injected with streptozotocin(65 mg/kg )to establish diabetic model.After 12 weeks,the diabetic rats were infused with DIZE at 15 mg· kg-1 · d-1 or the same volume of saline for 4 weeks using os-motic minipump.The cardiac function was measured at the end of the 16th week.The methods of Mason staining and HE staining were used to observe the morphological changes of the myocardial tissue.Western blot ,ELISA and immunohisto-chemistry were used to observe the changes of ACE2,angiotensin(Ang)Ⅱ,Ang-(1-7),interleukin(IL)-1,IL-6 and connective tissue growth factor(CTGF).RESULTS:DIZE significantly improved the expression of ACE 2 in diabetic rats(P<0.05).Compared with DCM group,the levels of IL-1 and IL-6 in DIZE group were significantly decreased ,and the cardiac function in DIZE group was significantly improved(P<0.05).CONCLUSION:ACE2 endogenous agonist DIZE significantly increases the ACE 2 level and reduces the level of inflammation ,thus protecting the heart function of DCM rats.

血管紧张素转换酶2(ACE2)是肾素-血管紧张素系统(RAS)的新成员,目前认为其与动脉粥样硬化、动脉瘤、冠心病心肌梗死、糖尿痛心肌病(DCM)及阿霉素心肌病(ACM)的过程密切相关.ACE2具有抑制血管重构及心肌重构的作用,在以上疾病的预防及治疗中具有重要意义.