Matrix Metalloproteases in Arterial Hypertension and their Trend after Antihypertensive Treatment

Background/Aims: Arterial hypertension is characterized by vascular remodelling, atherosclerosis and cardiovascular complications. Matrix metalloproteases (MPPs) are endopeptidases produced by all the cells present in the vascular wall and are involved in the regulation of the extracellular matrix protein turnover. MMPs contribute to blood vessel formation, remodelling, angiogenesis; whereas an altered expression or activity of MMPs or their tissue inhibitors (TIMPs) results correlated with the development and progression of cardiovascular complications. Methods: We examined the literature data regarding the role of MMPs in human hypertension, including their involvement in vascular remodelling, and the effects of some antihypertensive molecules on these MMP/TIMP profile. Results: The expression and the activity of some MMPs and TIMPs are impaired in human hypertension. An altered MMPs/TIMPs balance plays an important role in the vascular wall rearrangement, in response to hemodynamic changes which may induce myocardial hypertrophy and fibrosis leading to ventricular remodelling. Several studies have examined the effects of some antihypertensive molecules, such as ACE inhibitors, angiotensin receptor blockers, calcium-channel blockers, and aldosterone antagonists, on the MMPs/TIMPs profile by obtaining positive results. Conclusion: Considering the data taken into consideration, the authors believe that in clinical practice a strategic antihypertensive therapy directed to the MMPs profile, may be useful to decrease the risk of cardiovascular complications

Gelatinases and physical exercise: A systematic review of evidence from human studies

Matrix metalloproteinases (MMPs), particularly gelatinase A (MMP-2) and gelatinase B (MMP-9), as well as their tissue inhibitors (TIMP-1 and TIMP-2), are involved in the development of skeletal muscle tissue, in the repair process after muscle injury and in the adaptive modifications induced by physical exercise in skeletal muscle. This paper aims at reviewing results from human studies that investigated the role of gelatinases and their inhibitors in skeletal muscle response to acute physical exercise or training

Hemorheological abnormalities in human arterial hypertension

Blood rheology is impaired in hypertensive patients. The alteration involves blood and plasma viscosity, and the erythrocyte behaviour is often abnormal. The hemorheological pattern appears to be related to some pathophysiological mechanisms of hypertension and to organ damage, in particular left ventricular hypertrophy and myocardial ischemia. Abnormalities have been observed in erythrocyte membrane fluidity, explored by fluorescence spectroscopy and electron spin resonance. This may be relevant for red cell flow in microvessels and oxygen delivery to tissues. Although blood viscosity is not a direct target of antihypertensive therapy, the rheological properties of blood play a role in the pathophysiology of arterial hypertension and its vascular complications

Fluidity and cytosolic Ca2+ concentration of circulating polymorphonuclear leukocytes at baseline in some chronic and acute clinical conditions: review of our survey

Abstract. Objective: In this mini-review we describe the behavior of polymorphonuclear leukocyte (PMN) membrane fluidity and of PMN cytosolic Ca2+ concentration in some chronic and acute clinical conditions. Methods: PMN membrane fluidity was evaluated employing the fluorescent probe Fura-2AM, and PMN cytosolic Ca2+ concentration was evaluated using the fluorescent probe TMA-DPH. Results: From the determination of these two parameters investigated on resting PMNs, an almost constant increase in PMN cytosolic Ca2+ concentration in chronic clinical conditions, such as vascular atherosclerotic disease with and without diabetes mellitus, essential hypertension, chronic kidney disease, and diabetes mellitus of both types, and a decrease in PMN membrane fluidity in acute clinical conditions, such as juvenile acute myocardial infarction and acute ischemic stroke, are evident. Conclusion: The possible reasons for this different behavior are analyzed on the basis of pathophysiological considerations

Short-Term Prognosis of Juvenile Myocardial Infarction: Role of Plasma Viscosity

In our early research1 regarding the hemorheological pattern in patients with acute myocardial infarction (AMI) with a mean age of 61.45 + 10.99 years, we showed that the major hemorheological parameters were almost normalized 2 weeks after the acute event. In the last decade, we focused on hemorheological parameters in juvenile myocardial infarction (JMI), defined as AMI in patients aged 45 years, in the \u2018\u2018Sicilian study on juvenile myocardial infarction\u2019\u2019

Behaviour of the neutrophil to lymphocyte ratio in young subjects with acute myocardial infarction

In the last years the neutrophil to lymphocyte ratio (NLR) has been examined in cardiovascular disorders and in particular in coronary artery disease and acute myocardial infarction (AMI). Now we examined this parameter in subjects with juvenile myocardial infarction at the initial stage and after 3 and 12 months. We enrolled 123 young subjects (112 men and 11 women, mean age 39.4\ub15.8 yrs) with AMI. The time interval between the AMI onset and the investigation was 13\ub17 days. The mean value of NLR observed in young AMI subjects was significantly increased compared to normal controls (N = 1.817\ub10.711; young AMI subjects = 2.376\ub10.873, p < 0.0001). NLR does not discriminate STEMI (2.427\ub10.878) and non STEMI (2.392\ub10.868) or diabetics (2.604\ub11.000) and non diabetics (2.324\ub10.853), but it differentiates smokers (2.276\ub10.853) and non smokers (2.837\ub11.072). NLR at the initial stage is not correlated with the number of cardiovascular risk factors or with the extent of the coronary disease. In this study we found a significant decrease of neutrophil count at 3 and 12 months later AMI without any significant variation of lymphocyte and consequently we observed a decrease in NLR at these two intervals of time in comparison with the initial stage. Despite some limitations present in this study, it is interesting to underline that also in juvenile myocardial infarction this low-cost haematological marker may be considered together with other inflammatory indicators

Analysis of the correlations between oxidative stress, gelatinases and their tissue inhibitors in the human subjects with obstructive sleep apnea syndrome

Obstructive sleep apnea syndrome (OSAS) is commonly associated with endothelial dysfunction, atherosclerosis and cardiovascular disorders. On the basis of this observation, our aim was to examine the oxidative status and the matrix metalloproteases (MMP) profile in a group of subjects with OSAS. We enrolled 48 subjects with OSAS defined after a 1-night cardiorespiratory sleep study, who were subsequently subdivided in two subgroups according to the severity of OSAS (low grade = L-OSAS; high grade= H-OSAS). We measured the parameters of oxidative stress, such as lipid peroxidation, protein oxidation, total antioxidant status (TAS), nitric oxide metabolites (NOx), and the plasma concentrations of the gelatinases (MMP-2 and MMP-9) and their tissue inhibitors (TIMP-1 and TIMP-2). We found a significant impairment of oxidative status in H-OSAS compared to L-OSAS and higher plasma levels of MMP-9 and TIMP-1 in H-OSAS compared to L-OSAS. In this study we observed a positive correlation between TBARS and MMP-9, a positive correlation between PC and MMP-9, and a negative correlation between NOx and MMP-9, especially in the whole group of OSAS subjects. These data underline how strong interrelationships among some parameters of the oxidative stress, in particular those reflecting lipid peroxidation, protein oxidation and NOx, and MMP-9 are evident in OSAS subjects. All these information may be useful in the clinical practice keeping in mind the cardiovascular complications generally accompanying the obstructive sleep apnea syndrome

Erythrocyte deformability, plasma lipid peroxidation and plasma protein oxidation in a group of OSAS subjects

Considering that obstructive sleep apnea syndrome (OSAS) is usually associated with endothelial dysfunction, atherosclerosis and cardiovascular disorders, our aim was to examine the erythrocyte deformability and the oxidative status in a group of OSAS subjects. We consecutively enrolled 48 subjects with OSAS defined after a 1-night cardiorespiratory sleep study, subsequently subdivided according to the apnea/hypopnea index (AHI) value in two subgroups: Low (L = 21 subjects with AHI30). We evaluated the erythrocyte deformability, expressed as elongation index (EI) and the parameters of the oxidative status, such as lipid peroxidation (expressed as thiobarbituric acid-reactive substances TBARS) and protein oxidation (measured as carbonyl groups PC). In the entire group and in the two subgroups of OSAS subjects we found a decreased erytrocyte deformability at all shear stresses, not correlated with the plasmatic oxidative stress nor with the polysomnographic parameters. Lipid peroxidation was increased in the whole group and in the H subgroup of OSAS while protein oxidation showed a different trend. As in OSAS the osmotic fragility and the metabolism of the red cells seem to be not impaired, the oxidative damage to the red cell membrane proteins might be responsible for the reduced erythrocyte deformability. This rheological alteration, in addition to the increase in whole blood and plasma viscosity and to the erythrocyte hyperaggregation, could influence the microcircolatory profile in OSAS subjects

Lipid peroxidation and nitric oxide metabolites in a group of subjects with obstructive sleep apnea syndrome

It is known that in OSAS the plasma lipid peroxidation has an opposite behavior in comparison with nitric oxide metabolites. In the re-examination of our survey of OSAS infjects we calculated the ratio between thiobarbituric acid reactive infstances (TBARS) and nitric oxide metabolites (NOx) in relation to OSAS severity. The study has regarded 48 OSAS infjects infdivided in two infgroups according to the apnea/hypopnea index-AHI-(Low=21 infjects with AHI 30). From the obtained data it is evident that the TBARS/NOx ratio is significantly higher in the H infgroup compared to L infgroup as well as this ratio is reduced in L infgroup in comparison with the whole group of OSAS infjects. In the entire group of OSAS infjects the TBARS/NOx ratio results positively correlated with AHI and ODI and inversely correlated with mSO2

Examining the Effect of Physician Language on Physician Impressions

Previous research provides evidence that stigma can be perpetuated through language with consequences for well-being and quality of care. For example, providers who use stigmatizing language transmit bias toward patients with implications for care provided by other healthcare professionals. The current work extends upon this research by investigating perceptions of physicians who use stigmatizing or humanizing language. The current work sought to document the negative consequences of providers’ indelicate language on impressions of the provider, thereby motivating thoughtful language choices. To this end, the current work experimentally manipulated the language (stigmatizing, identity-first and destigmatizing, person-first) that hypothetical providers used to describe individuals with substance use disorder and examined participants’ judgments of the providers (likeability and positive behavioral intentions). We predicted that the provider using stigmatizing, identity-first language would elicit more negative responses than the provider using destigmatizing, person-first language. However, the results provided no support for this hypothesis; instead, we observed only an effect of the vignette content: participants had more positive perceptions of the physician who spoke first, compared to the physician who spoke second. Although the current work did not observe significant effects of language, past work indicates the importance of empathy, warmth, and respect from providers for patient well-being and outcome. We suggest directions for improving upon the current study, as well as possible topics for future research that may aid in understanding these important antecedents of inclusive and successful patient-physician interactions