HDAC9 is implicated in atherosclerotic aortic calcification and affects vascular smooth muscle cell phenotype.

Aortic calcification is an important independent predictor of future cardiovascular events. We performed a genome-wide association meta-analysis to determine SNPs associated with the extent of abdominal aortic calcification (n = 9,417) or descending thoracic aortic calcification (n = 8,422). Two genetic loci, HDAC9 and RAP1GAP, were associated with abdominal aortic calcification at a genome-wide level (P < 5.0 × 10-8). No SNPs were associated with thoracic aortic calcification at the genome-wide threshold. Increased expression of HDAC9 in human aortic smooth muscle cells promoted calcification and reduced contractility, while inhibition of HDAC9 in human aortic smooth muscle cells inhibited calcification and enhanced cell contractility. In matrix Gla protein-deficient mice, a model of human vascular calcification, mice lacking HDAC9 had a 40% reduction in aortic calcification and improved survival. This translational genomic study identifies the first genetic risk locus associated with calcification of the abdominal aorta and describes a previously unknown role for HDAC9 in the development of vascular calcification

Correlation of carotid blood flow and corrected carotid flow time with invasive cardiac output measurements

Abstract Background Non-invasive measures that can accurately estimate cardiac output may help identify volume-responsive patients. This study seeks to compare two non-invasive measures (corrected carotid flow time and carotid blood flow) and their correlations with invasive reference measurements of cardiac output. Consenting adult patients (n = 51) at Massachusetts General Hospital cardiac catheterization laboratory undergoing right heart catheterization between February and April 2016 were included. Carotid ultrasound images were obtained concurrently with cardiac output measurements, obtained by the thermodilution method in the absence of severe tricuspid regurgitation and by the Fick oxygen method otherwise. Corrected carotid flow time was calculated as systole time/√cycle time. Carotid blood flow was calculated as π × (carotid diameter)2/4 × velocity time integral × heart rate. Measurements were obtained using a single carotid waveform and an average of three carotid waveforms for both measures. Results Single waveform measurements of corrected flow time did not correlate with cardiac output (ρ = 0.25, 95% CI −0.03 to 0.49, p = 0.08), but an average of three waveforms correlated significantly, although weakly (ρ = 0.29, 95% CI 0.02–0.53, p = 0.046). Carotid blood flow measurements correlated moderately with cardiac output regardless of if single waveform or an average of three waveforms were used: ρ = 0.44, 95% CI 0.18–0.63, p = 0.004, and ρ = 0.41, 95% CI 0.16–0.62, p = 0.004, respectively. Conclusions Carotid blood flow may be a better marker of cardiac output and less subject to measurements issues than corrected carotid flow time

MicroRNA-425 and microRNA-155 cooperatively regulate atrial natriuretic peptide expression and cGMP production

Aims Atrial natriuretic peptide (ANP), secreted primarily by atrial cardiomyocytes, decreases blood pressure by raising cyclic 3’,5’-guanosine monophosphate (cGMP) levels and inducing vasorelaxation, natriuresis, and diuresis. Raising the level of ANP has been shown to be an effective treatment for hypertension. To advance the future development of an anti-microRNA (miR) approach to increasing expression of ANP, we investigated the regulation of NPPA expression by two miRs: miR-425 and miR-155. We examined whether miR-425 and miR-155 have an additive effect on the expression and function of ANP. Methods and results Human embryonic stem cell-derived cardiomyocytes (hESC-CMs) were transfected with miR-425, miR-155, or a combination of the two miRs. Two days later, NPPA expression was measured using real time qPCR. Each of the miRs decreased NPPA expression over a wide range of concentrations, with a significant reduction at concentrations as low as 1 nM. The combination of miR-425 and miR-155 reduced NPPA expression to a greater extent than either miR-425 or miR-155 alone. An in vitro assay was developed to study the potential biological significance of the miR-induced decrease in NPPA expression. The cooperative effect of miR-425 and miR-155 on NPPA expression was associated with a significant decrease in cGMP levels. Conclusions: These data demonstrate that miR-425 and miR-155 regulate NPPA expression in a cooperative manner. Targeting both miRNAs with anti-miRs (possibly at submaximal concentrations) might prove to be a more effective strategy to modulate ANP levels, and thus blood pressure, than targeting either miRNA alone

MyD88-Dependent Immune Activation Mediated by Human Immunodeficiency Virus Type 1-Encoded Toll-Like Receptor Ligands▿

Immune activation is a major characteristic of human immunodeficiency virus type 1 (HIV-1) infection and a strong prognostic factor for HIV-1 disease progression. The underlying mechanisms leading to immune activation in viremic HIV-1 infection, however, are not fully understood. Here we show that, following the initiation of highly active antiretroviral therapy, the immediate decline of immune activation is closely associated with the reduction of HIV-1 viremia, which suggests a direct contribution of HIV-1 itself to immune activation. To propose a mechanism, we demonstrate that the single-stranded RNA of HIV-1 encodes multiple uridine-rich Toll-like receptor 7/8 (TLR7/8) ligands that induce strong MyD88-dependent plasmacytoid dendritic cell and monocyte activation, as well as accessory cell-dependent T-cell activation. HIV-1-encoded TLR ligands may, therefore, directly contribute to the immune activation observed during viremic HIV-1 infection. These data provide an initial rationale for inhibiting the TLR pathway to directly reduce the chronic immune activation induced by HIV-1 and the associated immune pathogenesis

Veno‐venous extracorporeal blood phototherapy increases the rate of carbon monoxide (CO) elimination in CO‐poisoned pigs

Background and objectives: Carbon monoxide (CO) inhalation is the leading causeof poisonrelated deaths in the United States. CO binds to hemoglobin (Hb),displaces oxygen, and reduces oxygen delivery to tissues. The optimal treatmentfor CO poisoning in patients with normal lung function is the administration ofhyperbaric oxygen (HBO). However, hyperbaric chambers are only available inmedical centers with specialized equipment, resulting in delayed therapy. Visiblelight dissociates CO from Hb with minimal effect on oxygen binding. In a pre-vious study, we combined a membrane oxygenator with phototherapy at 623 nmto produce a “mini” photoECMO (extracorporeal membrane oxygenation) de-vice, which improved CO elimination and survival in CO-poisoned rats. Theobjective of this study was to develop a larger photoECMO device (“maxi”photo-ECMO) and to test its ability to remove CO from a porcine model of CO poisoning. Study design/materials and methods: The “maxi” photoECMO device and thephoto-ECMO system (six maxi photo-ECMO devices assembled in parallel), were tested in an in vitro circuit of CO poisoning. To assess the ability of the photo-ECMO device and the photoECMO system to remove CO from CO-poisonedblood in vitro, the half-life of COHb (COHb-t1/2), as well as the percent COHbreduction in a single blood pass through the device, were assessed. In the in vivostudies, we assessed the COHb-t1/2in a CO-poisoned pig under three conditions:(1) While the pig breathed 100% oxygen through the endotracheal tube; (2) whilethe pig was connected to the photo-ECMO system with no light exposure; and (3)while the pig was connected to the photo-ECMO system, which was exposed to red light. Results: The photo-ECMO device was able to fully oxygenate the blood after asingle pass through the device. Compared to ventilation with 100% oxygen alone,illumination with red light together with 100% oxygen was twice as efcient inremoving CO from blood. Changes in gas flow rates did not alter CO eliminationin one pass through the device. Increases in irradiance up to 214 mW/cm2wereassociated with an increased rate of CO elimination. The photo-ECMO devicewas effective over a range of blood flow rates and with higher blood flow rates,more CO was eliminated. A photo-ECMO system composed of six photo-ECMOdevices removed CO faster from CO-poisoned blood than a single photo-ECMOdevice. In a CO-poisoned pig, the photo-ECMO system increased the rate of CO elimination without significantly increasing the animal's body temperature orcausing hemodynamic instability. Conclusion: In this study, we developed a photo-ECMO system and demonstrated its ability to remove CO from CO-poisoned 45-kg pigs. Technical modificaitons of the photo-ECMO system, including the development of a compact, portable device, will permit treatment of patients with CO poisoning at the scene of their poisoning, during transit to a local emergency room, and in hospitals that lack HBO facilities

MiR-425 and miR-155 produced an additive decrease in cGMP levels relative to either miRNA alone.

<p>Cardiomyocytes were transfected with 1 nM (A) or 5 nM (B) of negative control miRNA (NC), miR-425, miR-155, or the combination of miR-425 and miR-155, each at half the concentration of the other miRs. Cyclic GMP levels were measured in NPR1-expressing cells that were incubated for 2 hours with media collected from the cardiomyocytes. Cyclic GMP levels were expressed as picomoles of cGMP per mg of protein and were shown relative to levels in cells exposed to media from cardiomyocytes transfected with negative control miRNA. *<i>P</i><0.01 and **<i>P</i><1x10^-6 versus cells transfected with negative control miRNA. N = 3 experiments (4–12 replicate wells for each condition) for (A) and n = 8 experiments (4 replicate wells per condition) for (B).</p