Improvement In Endothelium-dependent Relaxation Research Articles

#2810 Exploring non-renal vasculature: therapeutic implications of proton pump inhibitor and anthelmintic treatment in PCK rat model

Abstract Background and Aims Cystic kidney diseases represent ciliopathies that can cause vascular damage through renal hypertension. Additionally, there is growing experimental evidence of endothelial cell abnormalities associated with ciliary protein deficiencies. PCK rats, a strain derived from Sprague-Dawley (SD) rats that develops both polycystic kidney disease (PKD) and liver disease, serve as a model for recessive PKD. The PCK rat model also presents abnormalities in non-renal vascular function. Another study from our group suggests a potential therapeutic benefit of repurposed therapy with a proton pump inhibitor (PPi) and an anthelmintic agent in attenuating the progression of PKD in a PCK rat model. Here, we investigated whether these drugs can also improve endothelial function. Method The compounds were administered to 3-week-old male and female PCK rats (n = 5-6) for a total of 10 weeks. Untreated PCK rats and age-matched SD rats (n = 5-6) served as controls. After perfusion fixation, the aorta was harvested and its thoracic rings were used to evaluate the contraction/relaxation responses ex vivo by organ bath experiments. Additional rings were preserved for histological and molecular biological analyses. Results Male PCK rats exhibited impaired endothelial function compared to healthy controls. Endothelium-dependent relaxation to acetylcholine was improved by 10% after treatment with PPi, while the anthelmintic administration had no protective effect. PKD also impaired endothelial function in female PCK rats compared to healthy SD controls. There was an improvement in endothelium-dependent relaxation to acetylcholine after treatment with PPi by 5.5%, while administration of the anthelmintic agent further impaired endothelial function. Conclusion 13-week-old PCK rats show endothelial dysfunction in non-renal vasculature. Treatment with a proton pump inhibitor improved endothelial function in male PCK rats to the level of healthy SD controls. By contrast, in a parallel study, the anthelmintic had a positive effect on renal function but a detrimental impact on endothelial function. These intricate relationships underscore the need for further exploration to understand the underlying mechanisms and broader implications of our findings, illustrating the challenges and potential avenues for the development of effective treatments for PKD.

Black Seed (<i>Nigella sativa</i>) oil restores smoke or nicotine-induced vascular impairment via improvement in endothelium-dependent relaxation: role of nitric oxide synthase and voltage-sensitive potassium channels

Background: Despite the overwhelming evidence linking smoking and nicotine intake with vascular function impairments, the mechanisms involved and the possible ameliorative effect of black seed (Nigella sativa (NS)) oil administration are not clearly understood. This study sought to determine the involvement of nitric oxide synthase and voltage-sensitive potassium channels in the modulation of vascular reactivity in cigarette or nicotine-exposed rats treated with NS oil.
 Methods: Thirty male Sprague-Dawley rats were divided into 6 groups comprising vehicle control (Control), NS oil only (NS), Smoke only (SMK), Smoke + NS oil (SMKNS), Nicotine only (NCT) and Nicotine + NS oil (NCTNS). Animals were either passively exposed to cigarette smoke or nicotine vapour for 12 weeks, however, NS oil treatment commenced from 9th-12th week orally. At the end of the 12-week experimental period, vascular reactivity to norepinephrine (NE), acetylcholine (ACh) and sodium nitroprusside (SNP) were assessed with or without the presence of L-nitro-arginine (LNA) or 4-Amino-pyridine (4AP).
 Results: Percent contractile response to NE was higher (p < 0.01) while relaxation response to ACh was lower in the SMK and NCT (p < 0.05) groups. LNA-induced inhibition to ACh was significantly reduced in both SMK and NCT groups. 4AP-induced inhibition to ACh was significantly increased only in the NCT group. 4AP-induced inhibition to SNP was increased in SMK group. NS oil reduced only contractile response to NE in NCT group. It also significantly improved relaxation response to ACh as well as restored LNA-induced inhibition to ACh in the SMK and NCT groups. Interestingly, while NS oil reduced 4AP-induced inhibition in the NCT group, it reduced 4AP-induced inhibition to SNP in the SMK group.
 Conclusion: NS oil ameliorates vascular dysfunction by reducing contractile response in rats exposed to nicotine vapour while increasing endothelium-dependent relaxation as well as restoring differentially both LNA- and 4AP-induced inhibition in rats exposed to cigarette smoke and nicotine vapour.

Influence of type-4 dipeptidyl peptidase inhibition on endothelium-dependent relaxation of aortae from a db/db mouse model of type 2 diabetes: a comparison with the effect of glimepiride.

PurposeThe aim of this study was to investigate the effects of the type-4 dipeptidyl peptidase (DPP-4) inhibitors linagliptin and vildagliptin as well as the sulfonylurea glimepiride on endothelium-dependent relaxation of aortae from female db/db mice with established hyperglycemia to determine whether these treatments were able to attenuate diabetes-induced endothelial dysfunction.Materials and methodsThe mice were treated with glimepiride (2 mg/kg po per day, weeks 1–6, n=12), glimepiride plus vildagliptin (glimepiride 2 mg/kg po per day, weeks 1–6; vildagliptin 3 mg/kg po per day, weeks 4–6, n=11), glimepiride plus linagliptin (glimepiride 2 mg/kg po per day, weeks 1–6; linagliptin 3 mg/kg po per day, weeks 4–6, n=11) or linagliptin (3 mg/kg po per day, weeks 1–6, n=12). Endothelium-dependent relaxation using acetylcholine was assessed in the absence and presence of pharmacological tools (TRAM-34 1 μM; apamin 1 μM; N-nitro-L-arginine [L-NNA] 100 μM; 1H-[1,2,4]oxadiazolo [4,3-a]quinoxalin-1-one [ODQ] 10 μM) to distinguish relaxation mediated by nitric oxide (NO).ResultsLinagliptin was associated with a significant improvement in endothelium-dependent relaxation (ACh Rmax; db/db 41±1%, linagliptin 73±6%, p<0.05). The enhanced response was maintained in the presence of TRAM-34+ apamin (ACh Rmax; db/db 23±6%, linagliptin 60±6%, p<0.01), ie, when the endothelium-dependent relaxation was mediated by NO. There was no evidence for a contribution from KCa channel opening to responses under any conditions. Glimepiride had no effect on endothelium-dependent relaxation when given alone (ACh Rmax 38±3%). The addition of linagliptin or vildagliptin to glimepiride did not significantly improve endothelium-dependent relaxation. All treatments caused some decrease in aortic superoxide production but the effect of linagliptin was significantly greater than glimepiride (linagliptin 534±60 relative luminescence unit [RLU], glimepiride 1471±265 RLU, p<0.05).ConclusionLinagliptin is superior to glimepiride in regard to the preservation of endothelium-dependent relaxation in the presence of hyperglycemia and the improvement in endothelial function in response to linagliptin treatment is associated with greater antioxidant activity compared to glimepiride.

Abstract P132: Everolimus, a Targeted Cancer Therapy, Improves Endothelium Dependent Relaxation in Spontaneously Hypertensive Rat Mesenteric Arteries

Cardiovascular disease is the leading cause of death in cancer survivors. The short-term and long-term cardiotoxic effects of targeted chemotherapeutics is not well known. Everolimus, an inhibitor to mammalian target of rapamycin (mTOR) complex 1, is a targeted therapy approved for the treatment of metastatic breast, colon, renal cell and pancreatic cancer. Clinical retrospective reviews suggest heart failure and hypertension as cardiotoxic effects of everolimus. Our lab previously showed that everolimus exposure on normotensive vessels increased sensitivity to adrenergic stimuli in a time and concentration dependent manner. We hypothesized that everolimus leads to enhanced contractility and impaired relaxation in hypertensive vessels. We studied the effects of everolimus on the contractility and relaxation of mesenteric resistance arteries (MRA) of male Wistar rats (12-15 weeks old, n=4) and spontaneously hypertensive rats (SHR) (15-18 weeks old, n=2) on a wire myograph. Two concentrations of everolimus were evaluated, 0.1μM and 0.1nM, during a one-hour incubation. Normotensive MRA exposed to everolimus (0.1μM) showed a decreased contractile response to phenylephrine (LogEC50 + SEM, Ctrl:-5.627 + 0.07 vs Drug: -5.390 + 0.10) but no difference when exposed to 0.1nM. SHR MRA showed no difference in PE-induced contraction at 0.1μM (LogEC50 + SEM, Ctrl:-5.638 + 0.08 vs Drug:-6.286 + 0.36) or 0.1nM (LogEC50 + SEM, Ctrl:-5.638 + 0.08 vs Drug:-5.332 + 0.16). No differences were observed in endothelium dependent relaxation response to acetylcholine (ACh) for either drug concentration in the normotensive vessels; however, SHR MRA exhibited enhanced sensitivity to ACh with everolimus exposure (LogEC50 + SEM, Ctrl: -6.851 + 0.15 vs Drug:-9.233 + 0.37 at 0.1nM; LogEC50 + SEM, Ctrl: -6.851 + 0.15 vs Drug:-8.244 + 0.34 at 0.1μM). Our data show that everolimus affects contractility in normotensive vessels, while affecting the dilatory response in SHR vessels with an improvement in endothelium-dependent relaxation. Everolimus may be a good therapeutic agent for hypertensive cancer patients. However, long term treatments with this targeted therapy need to be evaluated for vascular dysfunction induction, which could be associated with cardiotoxicity.

Involvement of bilitranslocase and beta-glucuronidase in the vascular protection by hydroxytyrosol and its glucuronide metabolites in oxidative stress conditions

Olive oil vascular benefits have been attributed to hydroxytyrosol (HT). However, HT biological actions are still debated because it is extensively metabolized into glucuronides (GCs). The aim of this study was to test HT and GC vasculoprotective effects and the underlying mechanisms using aorta rings from 8-week-old male Wistar rats. In the absence of oxidative stress, incubation with 100 μM HT or GC for 5 min did not exert any vasorelaxing effect and did not influence the vascular function. Conversely, in condition of oxidative stress [upon incubation with 500 μM tert-butylhydroperoxide (t-BHP) for 30 min], preincubation with HT or GC improved acetylcholine-induced vasorelaxation compared with untreated samples (no t-BHP). This protective effect was lost for GC, but not for HT, when a washing step (15 min) was introduced between preincubation with HT or GC and t-BHP addition, suggesting that only HT enters the cells. In agreement, bilitranslocase inhibition with 100 μM phenylmethanesulfonyl fluoride for 20 min reduced significantly HT, but not GC, effect on the vascular function upon stress induction. Moreover, GC protective effect (improvement of endothelium-dependent relaxation in response to acetylcholine) in oxidative stress conditions was reduced by preincubation of aorta rings with 300 μM D-saccharolactone to inhibit β-glucuronidase, which can deconjugate polyphenols. Finally, only HT was detected by high-pressure liquid chromatography in aorta rings incubated with GC and t-BHP. These results suggest that, in conditions of oxidative stress, GC can be deconjugated into HT that is transported through the cell membrane by bilitranslocase to protect vascular function.

A novel role for small molecule glycomimetics in the protection against lipid-induced endothelial dysfunction: Involvement of Akt/eNOS and Nrf2/ARE signaling

BackgroundGlycomimetics are a diverse array of saccharide-inspired compounds, designed to mimic the bioactive functions of glycosaminoglycans. Therefore, glycomimetics represent a unique source of novel therapies to target aberrant signaling and protein interactions in a wide range of diseases. We investigated the protective effects of four newly synthesized small molecule glycomimetics against lipid-induced endothelial dysfunction, with an emphasis on nitric oxide (NO) and oxidative stress. MethodsFour aromatic sugar mimetics were synthesized by the stepwise transformation of 2,5-dihydroxybenzoic acid to derivatives (C1–C4) incorporating sulfate groups to mimic the structure of heparan sulfate. ResultsGlycomimetic-treated human umbilical vein endothelial cells (HUVECs) were exposed to palmitic acid to model lipid-induced oxidative stress. Palmitate-induced impairment of NO production was restored by the glycomimetics, through activation of Akt/eNOS signaling. Furthermore, C1-C4 significantly inhibited palmitate-induced reactive oxygen species (ROS) production, lipid peroxidation, and activity and expression of NADPH oxidase. These effects were attributed to activation of the Nrf2/ARE pathway and downstream activation of cellular antioxidant and cytoprotective proteins. In ex vivo vascular reactivity studies, the glycomimetics (C1–C4) also demonstrated a significant improvement in endothelium-dependent relaxation and decreased ROS production and NADPH oxidase activity in isolated mouse thoracic aortic rings exposed to palmitate. ConclusionsThe small molecule glycomimetics, C1–C4, protect against lipid-induced endothelial dysfunction through up-regulation of Akt/eNOS and Nrf2/ARE signaling pathways. Thus, carbohydrate-derived therapeutics are a new class of glycomimetic drugs targeting endothelial dysfunction, regarded as the first line of defense against vascular complications in cardiovascular disease.

Protective effect of a pomace olive oil concentrated in triterpenic acids in alterations related to hypertension in rats: Mechanisms involved

Despite the amount of information and research on the effects of virgin olive oil and its components in cardiovascular disease, little attention has been paid to the effects of pomace olive oil, an olive oil subproduct traditionally used in Spain. The aim of the present study was to evaluate the potential effects of a pomace olive oil concentrated in triterpenic acids (POCTA) on blood pressure, cardiac hemodynamics, and functional and molecular vascular alterations associated with hypertension in spontaneously hypertensive rats (SHR). The study showed that POCTA attenuated the increase of blood pressure in SHR. This effect was associated with an improvement in endothelium-dependent relaxation, enhancement of vascular expression of endothelial nitric oxide synthase, and reduction of tumor necrosis factor alpha, transforming growth factor beta, and collagen I. Furthermore, POCTA improved cardiac hemodynamics (left ventricular systolic pressure and left ventricular end-diastolic pressure) and decreased relative kidney and lung weights. POCTA exerts antihypertensive effects together with vascular and hypertension target organ protection in SHR. Since interest in pomace olive oil has been low, the results of this study contribute to increasing awareness of its biological and nutritional values.

Fish Oil Blunted Nicotine-Induced Vascular Endothelial Abnormalities Possibly via Activation of PPARγ-eNOS-NO Signals

Nicotine exposure is associated with an induction of vascular endothelial dysfunction (VED), a hallmark of various cardiovascular disorders. The present study investigated the effect of fish oil in nicotine-induced experimental VED. VED was assessed by employing isolated aortic ring preparation, estimating aortic and serum nitrite/nitrate, aortic superoxide anion generation, and serum TBARS, and carrying out electron microscopic and histological studies of thoracic aorta. Nicotine (2 mg/kg/day, i.p., 4 weeks) administration produced VED in rats by attenuating acetylcholine-induced endothelium-dependent relaxation in the isolated aortic ring preparation, decreasing aortic and serum nitrite/nitrate concentration, impairing endothelial integrity, and inducing vascular oxidative stress. Treatment with fish oil (2 mL/kg/day p.o., 4 weeks) markedly prevented nicotine-induced endothelial functional and structural abnormalities and oxidative stress. However, administration of GW9662, a selective inhibitor of PPARγ, to a significant degree attenuated fish oil-associated anti-oxidant action and vascular endothelial functional and structural improvements. Intriguingly, in vitro incubation of L-NAME (100 μM), an inhibitor of nitric oxide synthase (NOS), markedly attenuated fish oil-induced improvement in endothelium-dependent relaxation in the aorta of nicotine-administered rats. Nicotine administration altered the lipid profile by increasing serum total cholesterol, which was significantly prevented by fish oil treatment. The vascular protective potential of fish oil in preventing nicotine-induced VED may pertain to its additional properties (besides its lipid-lowering effect) such as activation of PPARγ and subsequent possible activation of endothelial NOS and generation of nitric oxide, and consequent reduction in oxidative stress.

261 Chronic administration of N-acetylcysteine: impact on endothelial dysfunction of epicardial coronary arteries associated with left ventricular hypertrophy in a porcine model

The aim of this study was to investigate the potential effect of chronic administration of N-acetylcysteine (NAC), a thiol drug with antioxidant properties, on the coronary endothelial dysfunction associated with LVH. Twenty-two 8-week-old Landrace male swine were randomly divided into 4 experimental groups. The control group (group 1) was submitted to a thoracotomy without aortic banding (AB). The untreated aortic banded group (group 2) was kept for 60 days. The first AB treated group (group 3) received 1000mg/day of NAC per os for 60 days starting on the day of the surgery. The second AB treated group (group 4) received the same oral dose of NAC for 30 days starting on day 30. Hypertrophy was assessed by echocardiography. Coronary vascular reactivity was evaluated in organ chambers. Nitrite/nitrate ratio and glutathione levels were measured to evaluate endothelial dysfunction. Finally, to assess oxidative stress, plasma lipid hydroperoxide levels (LPO) were measured. The LV mass/left ventricular diastolic diameter ratio was significantly higher in group 2 (37.6±10.0 g/cm) compared to group 1 (16.4±1.5 g/cm) confirming the development of LVH. This latest was found to be associated with a significant endothelial dysfunction (maximal relaxation to serotonin 76±2% versus 85±3% for group 1 and 2 respectively; maximal relaxation to bradykinin 100±0% versus 96±1% for group 1 and 2, respectively). NAC did not prevent LVH development in group 3 (30.5±2.3 g/cm; p>0.05 versus group 2) but attenuated its progression in group 4 (25.4±3.0 g/cm). Concentration response curves to NAC showed improvement in endothelium-dependent relaxation to serotonin (55±2% and 57±3% for group 3 and 4, respectively) and to bradykinin (99±1% and 99±1%). LPO levels were significantly lower in both treated group as compared to group 2 (p

Adoptive Transfer of Syngeneic Bone Marrow-Derived Cells in Mice with Obesity-Induced Diabetes: Selenoorganic Antioxidant Ebselen Restores Stem Cell Competence

There are conflicting data regarding the effects of transplantation of bone marrow-derived cells (BMDCs) on the severity of diabetes. We therefore inquired whether the competence of BMDCs is preserved on adoptive transfer into diabetic (db/db) mice and how the adoptive transfer of BMDCs affects vascular and metabolic abnormalities in these mice. Recipient db/db mice received infusions of BMDCs prepared from either db/db or non-diabetic heterozygout mice (db/m) mice and effects on endothelium-dependent relaxation, insulin sensitivity, and renal function were evaluated. Recipients of BMDCs from db/m, but not db/db donors showed better glucose control, exhibited striking improvement in endothelium-dependent relaxation in response to acetylcholine, and had partially restored renal function. Improved glucose control was due to enhanced insulin sensitivity, most likely secondary to improved vascular function. Enhanced apoptosis of endothelial progenitor cells under oxidative stress, as well as decreased endothelial progenitor cell numbers were responsible for the apparent functional incompetence of BMDCs from db/db donors. Treatment of db/db mice with Ebselen restored the resistance of both BMDCs and endothelial progenitor cells to oxidative stress, improved acetylcholine-induced vasorelaxation, and reduced proteinuria in db/db recipients of BMDC transplantation. In conclusion, infusion of BMDCs obtained from db/m donors to db/db recipient mice benefited macrovascular function, insulin sensitivity, and nephropathy. BMDCs obtained from db/db mice were functionally incompetent secondary to the increased proportion of apoptotic cells on oxidative stress challenge; their competence was restored by Ebselen therapy.

Low-Intensity Voluntary Running Lowers Blood Pressure with Simultaneous Improvement in Endothelium-Dependent Vasodilatation and Insulin Sensitivity in Aged Spontaneously Hypertensive Rats

Our objective is to examine the effects of voluntary running at different intensity levels on blood pressure, endothelium-dependent vessel dysfunction and insulin resistance in aged spontaneously hypertensive rats (SHR) with severe hypertension. Ten-month-old male and female SHR with severe hypertension were assigned to voluntary running at either low intensity (30% of maximal aerobic velocity) or moderate intensity (60% of maximal aerobic velocity) on a motor-driven treadmill for 6 weeks, 20 min per day and 7 days per week. Age-matched Wistar-Kyoto rats and SHR were kept under sedentary conditions as controls. Blood pressure and heart rate were measured by the tail-cuff method. At the end of the exercise training, blood samples were collected for glucose, insulin and lipids assay, and aortae were isolated to examine their function in vitro. Low-intensity but not moderate-intensity running significantly lowered blood pressure in both male and female SHR (p<0.01). There was significant impairment in acetylcholine-induced vasorelaxation in SHR (p<0.01), which was improved by low-intensity training (p<0.05). Nitric oxide synthase blockade abrogated the improvement in endothelium-dependent relaxation. Hypertensive rats had elevated blood glucose and insulin levels with lowered insulin sensitivity that was ameliorated by low-intensity running. A significant increase in blood high-density lipoprotein (HDL)-cholesterol and a significant decrease in triglycerides were found in exercised SHR. In conclusion, low-intensity voluntary exercise lowers hypertension in aged SHR with severe hypertension. Exercise-induced simultaneous improvement in endothelium-dependent vessel relaxation and insulin sensitivity may act concomitantly in attenuating cardiovascular risk factors in aged hypertensive rats with significantly high blood pressure.

Polyol pathway inhibition improves age‐related vascular dysfunction in rats

Altered glucose metabolism may contribute to age-related vascular dysfunction. Aging alters expression of polyol pathway enzymes and hence substrate flux via these enzymes. Aldose reductase (AR) is the rate-limiting enzyme in the polyol pathway. The effect of AR inhibitor Zopolrestat (ARI) on improving vascular dysfunction in aged rats was examined. Endothelium dependent relaxation (EDR) was measured in aortic rings from young and aged (4 vs. 26 months) Fisher 344 rats in organ baths. EDR to acetylcholine (Ach; 10−8–10−4M) was measured as % relaxation to phenylephrine±SEM. Rings were exposed to ARI (10 mM), and EDR with ARI and after washout were measured. EDR was impaired in aged rats compared with young rats. Exposure of the aged rings to ARI alone resulted in a significant vasodilation (73 ± 5). Further addition of Ach to these rings produced EDR similar to that seen in young rats. Following washout EDR was impaired, indicating that protection by ARI is reversible. The nitric oxide (NO) synthase inhibitor L-NAME (100 μM) did not prevent vasodilation to ARI, suggesting that improvement of EDR by ARI is not mediated by an increase in NO synthase-derived NO production. These data indicate that polyol pathway inhibitors may ameliorate agerelated vascular dysfunction. Supported by NIH HL61783

Transgenic activation of the kallikrein‐kinin system inhibits intramyocardial inflammation, endothelial dysfunction, and oxidative stress in experimental diabetic cardiomyopathy

The mechanisms contributing to diabetic cardiomyopathy, as well as the protective pathways of the kallikrein-kinin-system (KKS), are incompletely understood. In a kallikrein-overexpressing rat model of streptozotocin (STZ)-induced diabetic cardiomyopathy, we investigated the involvement of inflammatory pathways, endothelial dysfunction, and oxidative stress. Six weeks after STZ injection, impairment of left ventricular (LV) function parameters measured by a Millar-tip catheter (peak LV systolic pressure; dP/dtmax; dP/dtmin) was accompanied by a significant increment of ICAM-1 and VCAM-1 (CAMs) expression, as well as of beta2-leukocyte-integrins+ (CD18+, CD11a+, CD11b+) and cytokine (TNF-alpha and IL-1beta)-expressing infiltrates in male Sprague-Dawley (SD-STZ) rats compared with normoglycemic littermates. Furthermore, SD-STZ rats demonstrated a significant impairment of endothelium-dependent relaxation evoked by acetylcholine and significantly increased plasma TBARS (plasma thiobarbituric acid reactive substances) levels as a measure of oxidative stress. These diabetic cardiomyopathy-associated alterations were significantly attenuated (P<0.05) in diabetic transgenic rats expressing the human kallikrein 1 (hKLK1) gene with STZ-induced diabetes. CAMs expression, beta2-leukocyte-integrins+, and cytokine-expressing infiltrates correlated significantly with all evaluated LV function parameters. The multiple protective effects of the KKS in experimental diabetic cardiomyopathy comprise the inhibition of intramyocardial inflammation (CAMs expression, beta2-leukocyte-integrins+ infiltration and cytokine expression), an improvement of endothelium-dependent relaxation and the attenuation of oxidative stress. These insights might have therapeutic implications also for human diabetic cardiomyopathy.

Statin-Mediated Inhibition of Rho

See related article, pages 1014–1021 HMG-CoA reductase inhibitors (statins) are more than just cholesterol-lowering drugs. The effects of statins in the cardiovascular system include, among others, the improvement of endothelium-dependent relaxation, a reduction in the progression of arteriosclerosis, an antihypertensive effect and beneficial actions on cardiac function.1 The pleiotropic actions even extend beyond the cardiovascular system and have been suggested to attenuate the progression of osteoporosis, reduce the incidence or severity of dementia, type II diabetes, allograft organ rejection and inflammation.1 Some of the effects of statins are attributed to interactions of the drugs with cell surface receptors, effects on cytochrome P450 monoxygenases and actions on the PI3-kinase pathway. The most important mechanism for the pleiotropic effects, however, is the inhibition of small GTPases.2 Small GTPases, which include proteins of the Ras and Rho families, mediate essential cellular signals required for proliferation, migration, and gene expression.3 To elicit their biological effects, small GTPases have to be anchored in the plasma membrane by an isoprenoid tail. Isoprenoids are intermediates of the cholesterol de novo synthesis. By inhibiting the key enzyme of the cholesterol de novo synthesis, the HMG-CoA reductase, statins deplete the cell of these lipids and thus elicit the retention of small GTPases in the cytosol, where they cannot exert their biological actions2 (Figure 1). Figure 1. Activation of RhoA geranyltransferase (GTF) catalyzes geranylgeranylation of RhoA with geranylgeranylpyrophosphate, thereby allowing anchoring of RhoA in the membrane. Guanine exchange factors (GEF) activate GDP/GTP exchange of RhoA, In the GTP-bound state RhoA is functionally active. GTPase activating proteins (GAP) promote GTP hydrolysis by RhoA and thus RhoA inactivation. GDP-bound RhoA interacts with guanine dissociation inhibitors (GDI) through the geranylgeranyl tail. GDI stabilizes the inactive form of RhoA. …

MECHANISMS OF ISCHEMIA-INDUCED CAVERNOSAL SMOOTH MUSCLE RELAXATION IMPAIRMENT IN A RABBIT MODEL OF VASCULOGENIC ERECTILE DYSFUNCTION

Purpose To determine the effects of hypercholesterolemia and atherosclerosis-induced chronic cavernosal arterial insufficiency on cavernosal smooth muscle tone, nitric oxide synthase (NOS) activity and cavernosal tissue synthesis of constrictor eicosanoids. To study whether inhibition of the cyclooxygenase pathway by indomethacin and tissue treatment with nitric oxide (NO) precursor L-arginine improve hypercholesterolemia and ischemia-induced impaired endothelium-dependent and neurogenic relaxation of cavernosal tissue. Materials and Methods New Zealand White rabbits were divided into control (n = 10, fed a regular diet), hypercholesterolemia (Hch, n = 13, fed a diet containing 0.5% cholesterol) and chronic cavernosal ischemia (CCI, n = 14) groups. The CCI group underwent balloon de-endothelialization of iliac arteries and received a diet containing 0.5% cholesterol. After 16 weeks, we examined the effects of Hch and balloon de-endothelialization induced arterial occlusive disease on iliac arterial blood flow, reactivity of cavernosal tissue, cavernosal NOS activity and cavernosal tissue synthesis of constrictor eicosanoids. Results Histology revealed significant atherosclerotic arterial occlusive disease in the CCI group. Iliac artery blood flow in the CCI group was significantly reduced compared with the control and Hch groups. In the Hch and CCI groups, endothelium-dependent relaxation of cavernosal tissue to acetylcholine was significantly reduced compared with the control group. Electrical field stimulation-induced neurogenic relaxation and cavernosal NOS activity were significantly reduced in the CCI group but not in the Hch group. The basal release of cavernosal constrictor eicosanoids, prostaglandin F 2 alpha (PGF 2 alpha) and thromboxane A 2 (TXA 2) was significantly increased in the CCI group. Indomethacin increased endothelium-dependent relaxation in all groups and neurogenic relaxation in the CCI group, but failed to normalize the differences in relaxation between treated and control groups. In the presence of indomethacin, L-arginine improved endothelium-dependent relaxation of cavernosal tissue in the Hch group but did not normalize endothelium-dependent or neurogenic relaxations in the CCI group. Relaxation to NO donor sodium nitroprusside and papaverine was similar in cavernosal tissue from all groups. Conclusions Impairment of endothelium-dependent relaxation by Hch occurs secondary to disruption of the NO formation in cavernosal endothelium. Improvement of endothelium-dependent relaxation by L-arginine may suggest lack of availability of L-arginine in cavernosal tissue from the Hch animals. Impairment of endothelium-dependent and neurogenic relaxation by CCI occurs secondary to disruption of the NO formation due to an alteration in the expression or activity of NOS and increased output of constrictor eicosanoids in cavernosal tissue. These studies show that Hch and atherosclerosis-induced chronic cavernosal arterial insufficiency, beyond decreasing cavernosal perfusion pressure, also adversely affect smooth muscle relaxation mechanisms in cavernosal tissue.

Mechanisms of ischemia-induced cavernosal smooth muscle relaxation impairment in a rabbit model of vasculogenic erectile dysfunction.

To determine the effects of hypercholesterolemia and atherosclerosis-induced chronic cavernosal arterial insufficiency on cavernosal smooth muscle tone, nitric oxide synthase (NOS) activity and cavernosal tissue synthesis of constrictor eicosanoids. To study whether inhibition of the cyclooxygenase pathway by indomethacin and tissue treatment with nitric oxide (NO) precursor L-arginine improve hypercholesterolemia and ischemia-induced impaired endothelium-dependent and neurogenic relaxation of cavernosal tissue. New Zealand White rabbits were divided into control (n = 10, fed a regular diet), hypercholesterolemia (Hch, n = 13, fed a diet containing 0.5% cholesterol) and chronic cavernosal ischemia (CCI, n = 14) groups. The CCI group underwent balloon deendothelialization of iliac arteries and received a diet containing 0.5% cholesterol. After 16 weeks, we examined the effects of Hch and balloon de-endothelialization induced arterial occlusive disease on iliac arterial blood flow, reactivity of cavernosal tissue, cavernosal NOS activity and cavernosal tissue synthesis of constrictor eicosanoids. Histology revealed significant atherosclerotic arterial occlusive disease in the CCI group. Iliac artery blood flow in the CCI group was significantly reduced compared with the control and Hch groups. In the Hch and CCI groups, endothelium-dependent relaxation of cavernosal tissue to acetylcholine was significantly reduced compared with the control group. Electrical field stimulation-induced neurogenic relaxation and cavernosal NOS activity were significantly reduced in the CCI group but not in the Hch group. The basal release of cavernosal constrictor eicosanoids, prostaglandin F2alpha (PGF2alpha) and thromboxane A2 (TXA2) was significantly increased in the CCI group. Indomethacin increased endothelium-dependent relaxation in all groups and neurogenic relaxation in the CCI group, but failed to normalize the differences in relaxation between treated and control groups. In the presence of indomethacin, L-arginine improved endothelium-dependent relaxation of cavernosal tissue in the Hch group but did not normalize endothelium-dependent or neurogenic relaxations in the CCI group. Relaxation to NO donor sodium nitroprusside and papaverine was similar in cavernosal tissue from all groups. Impairment of endothelium-dependent relaxation by Hch occurs secondary to disruption of the NO formation in cavernosal endothelium. Improvement of endothelium-dependent relaxation by L-arginine may suggest lack of availability of L-arginine in cavernosal tissue from the Hch animals. Impairment of endothelium-dependent and neurogenic relaxation by CCI occurs secondary to disruption of the NO formation due to an alteration in the expression or activity of NOS and increased output of constrictor eicosanoids in cavernosal tissue. These studies show that Hch and atherosclerosis-induced chronic cavernosal arterial insufficiency, beyond decreasing cavernosal perfusion pressure, also adversely affect smooth muscle relaxation mechanisms in cavernosal tissue.

Improvement in the endothelium-dependent relaxation in hypercholesterolemic rabbits treated with vitamin E

The authors studied the time course of the vitamin E mediated improvement in endothelium-dependent relaxation in hypercholesterolemic rabbits. A total of 40 male New Zealand white rabbits were randomly assigned to hypercholesterolemic (control) and vitamin E treated groups. The latter group was further divided in three subgroups in accordance with the duration of the vitamin E treatment (2, 4 or 6 days) at the end of the experiment. The dose of vitamin E utilized was 50 IU/day administered once a day by gavage. All the rabbits were fed a diet supplemented with cholesterol (0.5%) and coconut oil (2%) for 4 weeks. At the end of this period, the animals were sacrificed and the aorta removed for determination of the cholesterol and malondialdehyde (MDA) contents. The relaxation of the aortic strips in response to acetylcholine was also studied. In addition, the cholesterol and MDA contents of native and oxidized LDL were measured. At the end of the 4th week, the MDA level was significantly reduced in native and oxidized LDL in the rabbits treated with vitamin E for 2 days, while in aortic tissue a reduction was seen after 4 days of treatment. Endothelium-dependent relaxation improved significantly after 6 days of vitamin E administration, and there was a reduction in the total plasma and aortic cholesterol levels during this same period. We conclude that vitamin E at a dose of 50 IU/day for 6 days improves the endothelium-dependent relaxation seen in hypercholesterolemic rabbits. This effect may be mediated through an antioxidant action on LDL particles and on the aortic arterial wall.

Rapid reversal of endothelial dysfunction in hypercholesterolaemic rabbits treated with simvastatin and pravastatin.

1. The main objective of the present study was to verify the speed with which two 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, simvastatin and pravastatin, could revert endothelial cell dysfunction in hypercholesterolaemic rabbits. An attempt was also made to correlate the plasma cholesterol level and the tissue cholesterol and malondialdehyde (MDA) contents of the aortae with the endothelium-dependent relaxation on the assumption that any endothelial dysfunction could be rapidly and partially reversed, even in the presence of relatively high serum cholesterol levels. 2. Ninety-one male New Zealand white rabbits were randomly assigned to hypercholesterolaemic (control), simvastatin or pravastatin groups. All rabbits were fed a diet supplemented with cholesterol (0.5%) and coconut oil (2%) for 8 weeks. Simvastatin (10 and 20 mg/day) and pravastatin (15 and 30 mg/day) were administered 6, 4 and 2 days before the end of the experiment. At the end of the 8th week, animals were killed and the aortae were removed for histological examination as well as for the measurement of cholesterol and MDA contents and for endothelium-dependent relaxation studies. 3. The results showed that significant improvement in endothelium-dependent relaxation was obtained only with pravastatin and only with 4 or 6 days of administration. In these cases, the cholesterol and MDA contents of the vessel wall were reduced, although no significant changes were observed in plasma total cholesterol. Higher doses of the drugs did not alter these results. 4. We conclude that pravastatin enhances endothelium-dependent relaxation when administered to cholesterol-fed rabbits, probably via an anti-oxidant action. This effect, which was observed to start on the 4th day of drug administration, may represent a new therapeutic approach for the treatment of acute coronary syndromes in hypercholesterolaemic patients.

Felodipine inhibits intimal lesion formation in the hypercholesterolemic rabbit: differential effects on endothelial and monocyte determinants of atherogenesis.

The purpose of this study was to determine if the calcium entry antagonist felodipine inhibited intimal lesion formation in hypercholesterolemic rabbits, and to determine if this was due to an effect upon monocyte and/or endothelial determinants of this interaction. Twenty-three male New Zealand White rabbits received the following treatment regimen for 10 weeks: normal chow (NP, n = 3); normal chow with felodipine infusion (NF, n = 6); 0.5% cholesterol chow (CP, n = 7); or 0.5% cholesterol chow and felodipine infusion (CF, n = 7). After 10 weeks blood was collected for biochemical measurements and mononuclear cell binding assays, and thoracic aortae were harvested for vascular reactivity studies and histomorphometry. In the animals receiving normal chow, felodipine did not significantly affect blood pressure, plasma cholesterol levels, binding studies, vascular reactivity, or structure; therefore these animals were analyzed as one group (N). Plasma cholesterol levels were significantly elevated in groups receiving the 0.5% cholesterol diet (N, 29 +/- 3 mg/dl; CP, 1221 +/- 73 mg/dl; CF, 979 +/- 108 mg/dl). High-density lipoprotein cholesterol was not different between the groups (25 +/- 4 vs 23 +/- 4 vs 27 +/- 4 mg/dl; N vs CF vs CP respectively; p = NS). Cholesterol feeding markedly augmented the adhesiveness of mononuclear cells, as demonstrated by a 250% increase in cell binding. Felodipine did not alter the adhesiveness of mononuclear cells in hypercholesterolemic animals. Cholesterol feeding significantly impaired endothelium-dependent relaxations. Endothelium-dependent relaxations were restored by felodipine treatment as reflected by the maximal responses to acetylcholine (40 +/- 7% vs 58 +/- 4% vs 67 +/- 5%; CP vs CF vs N respectively). The improvement in endothelium-dependent relaxation in the felodipine-treated animals was associated with a 2.2-fold reduction in lesion surface area of the thoracic aorta (8.2 +/- 6.3% vs 18.2 +/- 9.5%; CF vs CP; p < 0.01). Moreover, the intima/media ratio reflecting lesion thickness was substantially reduced by felodipine treatment (0.05 +/- 0.02 vs 0.20 +/- 0.07; CF vs CP; p = 0.006). Ex vivo studies revealed that felodipine inhibited the adhesiveness of vascular endothelium, but not mononuclear cells, derived from hypercholesterolemic animals. Low-dose felodipine appears to inhibit monocyte-endothelial interaction, as indicated by a reduction in the formation of lesions in hypercholesterolemic animals. This effect is not due to an alteration in adhesiveness of mononuclear cells. The salutary effect of felodipine is associated with an increase in vascular nitric oxide activity which may reduce endothelial adhesiveness.

Regression or Progression

We have shown that chronic administration of the nitric oxide (NO) precursor L-arginine inhibits atherogenesis in the hypercholesterolemic rabbit. However, the effect of supplemental arginine on preexisting lesions is not known and was the focus of the present study. New Zealand White rabbits received normal chow or 0.5% cholesterol chow for 10 weeks. Subsequently, L-arginine (2.25% in drinking water; ARG group) or vehicle (CHOL group) was administered for an additional 13 weeks, while the high-cholesterol diet was continued. Thoracic aortae were harvested at weeks 10, 14, 18, or 23. Rings of aorta were used to assess NO-dependent vasodilation to acetylcholine. Maximal relaxation to acetylcholine in the CHOL rabbits became progressively attenuated from 53.4% (at week 10) to 17.4% (by week 23). Planimetry of the luminal surface of the aortae from CHOL animals revealed a progressive increase in lesion surface area from 30.3% (at week 10) to 56.5% (by week 23). By contrast, animals in the ARG groups manifested improved endothelium-dependent relaxation associated with a reduction of lesion surface area at 14 and 18 weeks. The arginine-induced improvement in endothelium-dependent relaxation was associated with an increased generation of vascular NO and a reduced generation of vascular superoxide anion. By 23 weeks, 3 of 7 ARG animals had persistent improvement in NO-dependent vasodilation and exhibited a further reduction of lesion surface area tc 5.4%. We conclude that hypercholesterolemia induces a progressive loss of NO-dependent vasodilation associated with progressive intimal lesion formation. Administration of L-arginine to animals with preexisting intimal lesions augments vascular NO elaboration, reduces superoxide anion generation, and is associated with a reduction in lesion surface area. This is the first demonstration that restoration of NO activity can induce regression of preexisting intimal lesions and provides evidence that L-arginine therapy may be of potential clinical benefit.