Regulation of Cardiac Gene Expression by B-adrenergic Signaling and Heart Failure

Cardiac diseases such as coronary artery disease are the major causes of death around the world. Regulation of -adrenergic receptors by catecholamines is an important facet of understanding cardiac function in health and disease. Acute sympathetic activation of ARs results in an increase in cardiac output; however, sustained stimulation of the ARs is cytotoxic, leading to myocyte death and cardiac remodeling. -adrenergic blockers are a seminal class of drugs that play an important role in improving mortality and symptom control in various cardiac diseases. An important transcriptional regulatory protein target of -adrenergic signaling is MEF2, which plays a crucial role in cardiac gene expression during pathologic and physiological adaptation of the heart. In our experiments, we have observed a robust effect of -blockers on MEF2 transcriptional activity. Myocardial MEF2 responses to -blocker treatment indicates an important physiological linkage between -adrenergic signaling and MEF2 activity in the heart, which underpins changes in cardiac gene expression in response to -adrenergic blockade. In the first set of experiments, the link between MEF2 and cardiac survival pathways in the heart was examined. Collectively, data indicate a mechanism of the beneficial effects of acute 1AR blocker treatment through up-regulation of MEF2 activity, leading to cardiomyocyte survival. In the second set of experiments, changes in MEF2 activity and global gene transcription networks during heart failure and in response to chronic 1-blockade was studied. Together, data demonstrate that chronic 1-blockade inhibits myocardial MEF2 activity while also minimizing dynamic changes in heart failure associated transcriptome dynamics. Communally, both studies indicate molecular events resulting from 1-adrenergic blockade that result in positive effects on heart pathology. These studies define novel molecules and pathways involved in heart pathology that may represent new genetic or pharmacologic targets for heart failure therapies

Part I. SARS-CoV-2 triggered \u27PANIC\u27 attack in severe COVID-19

The coronavirus disease 2019 (COVID-19) pandemic has produced a world-wide collapse of social and economic infrastructure, as well as constrained our freedom of movement. This respiratory tract infection is nefarious in how it targets the most distal and highly vulnerable aspect of the human bronchopulmonary tree, specifically, the delicate yet irreplaceable alveoli that are responsible for the loading of oxygen upon red cell hemoglobin for use by all of the body\u27s tissues. In most symptomatic individuals, the disease is a mild immune-mediated syndrome, with limited damage to the lung tissues. About 20% of those affected experience a disease course characterized by a cataclysmic set of immune activation responses that can culminate in the diffuse and irreversible obliteration of the distal alveoli, leading to a virtual collapse of the gas-exchange apparatus. Here, in Part I of a duology on the characterization and potential treatment for COVID-19, we define severe COVID-19 as a consequence of the ability of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to trigger what we now designate for the first time as a ‘Prolific Activation of a Network-Immune-Inflammatory Crisis’, or ‘PANIC’ Attack, in the alveolar tree. In Part II we describe an immunotherapeutic hypothesis worthy of the organization of a randomized clinical trial in order to ascertain whether a repurposed, generic, inexpensive, and widely available agent is capable of abolishing ‘PANIC’; thereby preventing or mitigating severe COVID-19, with monumental ramifications for world health, and the global pandemic that continues to threaten it

Intracranial Nimodipine Implant: Feasibility and Implications for the Treatment of Subarachnoid Hemorrhage – A Pre-Clinical Study

Intracranial aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition requiring immediate neurocritical care. A ruptured aneurysm must be isolated from arterial circulation to prevent rebleeding. Open surgical clipping of the neck of the aneurysm or intra-arterial filling of the aneurysm sack with platinum coils are major treatment strategies in an acute phase. About 40% of the patients suffering from aSAH die within a year of the bleeding despite the intensive treatment. After aSAH, the patient may develop a serious complication called vasospasm. Major risk for the vasospasm takes place at days 5–14 after the primary bleeding. In vasospasm, cerebral arteries contract uncontrollably causing brain ischemia that may lead to death. Nimodipine (NDP) is used to treat of vasospasm and it is administrated intravenously or orally every four hours for 21 days. NDP treatment has been scientifically proven to improve patients’ clinical outcome. The therapeutic effect of L-type calcium channel blocker NDP is due to the ability to dilate cerebral arteries. In addition to vasodilatation, recent research has shown the pleiotropic effect of NDP such as inhibition of neuronal apoptosis and inhibition of microthrombi formation. Indeed, NDP inhibits cortical spreading ischemia. Knowledge of the pathophysiology of the vasospasm has evolved in recent years to a complex entity of early brain injury, secondary injuries and cortical spreading ischemia, instead of being pure intracranial vessel spasm. High NDP levels are beneficial since they protect neurons and inhibit the cortical spreading ischemia. One of the drawbacks of the intravenous or oral administration of NPD is systemic hypotension, which is harmful particularly when the brain is injured. Maximizing the beneficial effects and avoiding systemic hypotension of NDP, we developed a sustained release biodegradable NDP implant that was surgically positioned in the basal cistern of animal models (dog and pig). Higher concentrations were achieved locally and lower concentrations systemically. Using this treatment approach in humans, it may be possible to reduce incidence of harmful hypotension and potentiate beneficial effects of NDP on neurons. Intracellular calcium regulation has a pivotal role in brain plasticity. NDP blocks L-type calcium channels in neurons, substantially decreasing intracellular calcium levels. Thus, we were interested in how NDP affects brain plasticity and tested the hypothesis in a mouse model. We found that NDP activates Brain-derived neurotrophic factor (BDNF) receptor TrkB and its downstream signaling in a reminiscent of antidepressant drugs. In contrast to antidepressant drugs, NDP activates Akt, a major survival-promoting factor. Our group’s previous findings demonstrate that long-term antidepressant treatment reactivates developmental-type of plasticity mechanisms in the adult brain, which allows the remodeling of neuronal networks if combined with appropriate rehabilitation. It seems that NDP has antidepressant-like properties and it is able to induce neuronal plasticity. In general, drug induced neuronal plasticity has a huge potential in neurorehabilitation and more studies are warranted.Siirretty Doriast

Voltage-gating and assembly of split Kv10.1 channels

Voltage-gated ion channels allow ions to pass cell membrane upon changes of transmembrane electrical potential. Conformational changes in the voltage-sensing domain of the channel (VSD) are assumed to be transmitted to the pore domain (PD) through an alpha-helical linker between them (S4-S5 linker). We have previously shown that expression of VSD and PD as separate fragments results in functional Kv10.1 channels that retain voltage-dependence. Here we used such ‘split’ channels to investigate functional interactions between VSD and PD. We found that their electrophysiological properties greatly depend on where the S4-S5 linker is interrupted. Remarkably, wild-type-like channel behavior could be fully or largely restored by mutations of crucial linker amino acids, indicating that precise functional interactions between VSD and PD remain when they are not covalently bound. Voltage-Clamp Fluorometry measurements revealed that VSD motion is alerted in specific split channels, but these changes were subtler. Finally, the increased separation between VSD activation and channel opening in the split channel carrying a large deletion in the S4-S5 linker, as well as the failure of the PD expressed alone to give currents, suggest that the role of the VSD in the is to open the channel pore and prevent it from closing

Novel therapeutic approaches targeting the renin angiotensin system and associated peptides in hypertension and heart failure

Despite the success of renin-angiotensin system (RAS) blockade by angiotensin-converting enzyme (ACE) inhibitors and angiotensin II type 1 receptor (AT1R) blockers, current therapies for hypertension and related cardiovascular diseases are still inadequate. Identification of additional components of the RAS and associated vasoactive pathways, as well as new structural and functional insights into established targets, have led to novel therapeutic approaches with the potential to provide improved cardiovascular protection and better blood pressure control and/or reduced adverse side effects. The simultaneous modulation of several neurohumoral mediators in key interconnected blood pressure–regulating pathways has been an attractive approach to improve treatment efficacy, and several novel approaches involve combination therapy or dual-acting agents. In addition, increased understanding of the complexity of the RAS has led to novel approaches aimed at upregulating the ACE2/angiotensin-(1-7)/Mas axis to counter-regulate the harmful effects of the ACE/angiotensin II/angiotensin III/AT1R axis. These advances have opened new avenues for the development of novel drugs targeting the RAS to better treat hypertension and heart failure. Here we focus on new therapies in preclinical and early clinical stages of development, including novel small molecule inhibitors and receptor agonists/antagonists, less conventional strategies such as gene therapy to suppress angiotensinogen at the RNA level, recombinant ACE2 protein, and novel bispecific designer peptides

The iso-response method

Throughout the nervous system, neurons integrate high-dimensional input streams and transform them into an output of their own. This integration of incoming signals involves filtering processes and complex non-linear operations. The shapes of these filters and non-linearities determine the computational features of single neurons and their functional roles within larger networks. A detailed characterization of signal integration is thus a central ingredient to understanding information processing in neural circuits. Conventional methods for measuring single-neuron response properties, such as reverse correlation, however, are often limited by the implicit assumption that stimulus integration occurs in a linear fashion. Here, we review a conceptual and experimental alternative that is based on exploring the space of those sensory stimuli that result in the same neural output. As demonstrated by recent results in the auditory and visual system, such iso-response stimuli can be used to identify the non-linearities relevant for stimulus integration, disentangle consecutive neural processing steps, and determine their characteristics with unprecedented precision. Automated closed-loop experiments are crucial for this advance, allowing rapid search strategies for identifying iso-response stimuli during experiments. Prime targets for the method are feed-forward neural signaling chains in sensory systems, but the method has also been successfully applied to feedback systems. Depending on the specific question, “iso-response” may refer to a predefined firing rate, single-spike probability, first-spike latency, or other output measures. Examples from different studies show that substantial progress in understanding neural dynamics and coding can be achieved once rapid online data analysis and stimulus generation, adaptive sampling, and computational modeling are tightly integrated into experiments

The interaction between neuronal networks and gene networks

Periods of strong electrical activity can initiate neuronal plasticity leading to long-lasting changes of network properties. A key event in the modification of the synaptic connectivity after neuronal activity is the activation of new gene transcription. Moreover, calcium (Ca2+) influx is crucial for transducing synaptic activity into gene expression through the activation of many signalling pathways. In our work we are interested in studying changes in electrical activity and in gene expression profile at the network level. In particular, we want to understand the interplay between neuronal and gene networks to clarify how electrical activity can alter the gene expression profile and how gene expression profile can modify the electrical and functional properties of neuronal networks. Thus, we investigated the neuronal network at three different levels: gene transcription profile, electrical activity and Ca2+ dynamics. Blockage of GABAA receptor by pharmacological inhibitors such as gabazine or bicuculline triggers synchronous bursts of spikes initiating neuronal plasticity. We have used this model of chemically-induced neuronal plasticity to investigate the modifications that occur at different network levels in rat hippocampal cultures. By combining multielectrode extracellular recordings and calcium imaging with DNA microarrays, we were able to study the concomitant changes of the gene expression profile, network electrical activity and Ca2+ concentration. First, we have investigated the time course of the electrical activity and the molecular events triggered by gabazine treatment. The analysis of the electrical activity revealed three main phases during gabazine-induced neuronal plasticity: an early component of synchronization (E-Sync) that appeared immediately after the termination of the treatment persisted for 3 hours and was blocked by inhibitors of the MAPK/ERK pathway; a late component (L-Sync) -from 6 to 24 hours- that was blocked by inhibitors of the transcription. And, an intermediate phase, from 3 to 6 hours after the treatment, in which the evoke response was maximally potentiated. Moreover, gabazine exposure initiated significant changes of gene expression; the genomic analysis identified three clusters of genes that displayed a characteristic temporal profile. An early rise of transcription factors (Cluster 1), which were maximally up-regulated at 1.5 hours. More than 200 genes, many of which known to be involved in LTP were maximally up-regulated in the following 2-3 hours (Cluster 2) and then were down-regulated at 24 hours. Among these genes, we have found several genes coding for K+ channels and the HNC1 channels. Finally, genes involved in cellular homeostasis were up-regulated at longer time (Cluster 3). Therefore, this approach allows relating changes of electrical properties occurring during neuronal plasticity to specific molecular events. Second, we have investigated which sources of Ca2+ entry were involved in mediating the new gene transcription activated in response to bursting activity. Using Ca2+ imaging, a detailed characterization of Ca2+ contributions was performed to allow investigating which sources of Ca2+ entry could be relevant to induce gene transcription. At the same time, changes of gene expression were specifically investigated blocking NMDA receptors and L-, N- and P/Q-type VGCCs. Therefore, the analysis of the Ca2+ contribution and gene expression changes revealed that the NMDA receptors and the VGCCs specifically induced different groups of genes. Thus, the combination of genome-wide analysis, MEA technology and calcium imaging offers an attractive strategy to study the molecular events underlying long-term synaptic modification