Raf kinase inhibitor protein (RKIP) expression and function in uterine leiomyoma

I leiomiomi uterini (detti anche fibromi, miomi) sono tumori benigni che originano dallo strato muscolare dell’utero (miometrio) e rappresentano la principale indicazione dell’isterectomia nel mondo. I leiomiomi uterini colpiscono circa il 77% delle donne in eta fertile e circa il 25% di esse presenta tumori con sintomatologia clinica evidente, tra cui la presenza di forte o anomalo sanguinamento uterino, dolore o pressione pelvica, infertilità e aborti ricorrenti. È comunemente noto che questi tumori sono caratterizzati da una elevata proliferazione cellulare ed una eccessiva deposizione di matrice extracellulare (ECM). Si ritiene che la crescita dei leiomiomi dipenda dall’azione degli ormoni ovarici mediante elementi intermedi come citochine e fattori di crescita. La Proteina Inibitore della Raf Chinasi (RKIP) ha un ruolo emergente come regolatore in diversi pathway molecolari ed è associato a un numero crescente di malattie, essendo coinvolto indiverse vie di trasduzione del segnale. Lo scopo della presente tesi è stato quello di indagare la presenza e il ruolo dell’RKIP nel leiomioma. Abbiamo dimostrato che l’RKIP è espresso nel miometrio e nel leiomioma. Per individuare il ruolo dell’RKIP, abbiamo eseguito esperimenti in vitro con un composto chimico quale la locostatina, capace di legarsi all’RKIP bloccandolo. Abbiamo dimostrato che il trattamento con la locostatina porta all’attivazione della via di segnale MAPK (fosforilazione di ERK), fornendo una opportuna validazione dell’efficacia nel bloccare l’RKIP. Inoltre, abbiamo dimostrato che l'inibizione dell’RKIP con la locostatina riduce le componenti della ECM, tra cui il collagene 1A1, la fibronectina, e il versican. In aggiunta, l'inibizione dell’RKIP con la locostatina riduce la proliferazione cellulare e la migrazione sia nelle cellule miometriali che di leiomioma. Infine, abbiamo dimostrato che il trattamento con la locostatina riduce l’espressione del GSK3β. Pertanto, anche se l'attivazione delle MAPK dovrebbe far aumentare la proliferazione e la migrazione, la destabilizzazione e l’inattivazione del GSK3β porta alla riduzione della proliferazione e della migrazione delle cellule miometriali e di leiomioma.Uterine leiomyomas (fibroids, myomas) are benign (non-cancerous) tumors that origin from the smooth muscle layer of the uterus (myometrium), and are the most common indication for hysterectomy in the world. Uterine leiomyomas affect about 77% of women of reproductive-age, and approximately 25% of them bear clinically apparent tumors with symptoms like heavy or abnormal uterine bleeding, pelvic pain or pressure, infertility, and recurrent pregnancy loss. It is commonly known that these tumors are characterized by increased cell proliferation and excessive deposition of extracellular matrix (ECM). Growth of leiomyoma is thought to be dependent on ovarian hormones activity through intermediate elements such as cytokines and growth factors. Raf Kinase Protein Inhibitor (RKIP) has emerging roles as regulator of multiple signaling networks and is associated with an increasing number of diseases through its involvement with signal transduction pathways. The aim of the present thesis was to investigate the presence and the role of RKIP in leiomyoma. We demonstrated that RKIP is expressed in human myometrial and leiomyoma tissue. In order to define the RKIP role, we performed in vitro experiments with the chemical compound locostatin, known to bind and block RKIP. We showed that locostatin treatment results in the activation of the MAPK signal pathway (ERK phosphorylation), providing a powerful validation of our targeting protocol. Further, we showed that RKIP inhibition by locostatin reduces ECM components, including collagen1A1, fibronectin, and versican. Moreover, the inhibition of RKIP by locostatin impairs cell proliferation and migration in both leiomyoma and myometrial cells. Finally, we demonstrated that locostatin treatment reduced GSK3β expression. Therefore, even if the activation of MAPK pathway should increase proliferation and migration, the destabilization and inactivation of GSK3β leads to the reduction of proliferation and migration of myometrial and leiomyoma cells

Raf Kinase Inhibitor Protein (RKIP) expression and function in human myometrium and leiomyoma

Many growth factors been identified in human myometrium and leiomyoma and activate multiple signaling pathways in order to regulate major cellular processes, including proliferation and fibrosis which are linked to uterine leiomyoma development and growth. The Raf kinase inhibitor protein (RKIP) has emerging roles as regulator of multiple signaling networks including mitogen activated protein (MAP) kinase cascade, as well as interaction with glycogen synthase kinase 3 (GSK3). In our study, we aimed to investigate the presence of RKIP in human myometrium and leiomyoma as well as to determine the effect of locostatin (RKIP inhibitor) on extracellular matrix (ECM) production, proliferation and migration in human myometrial and leiomyoma cells. Myometrial and leiomyoma tissues were used to investigate the localization and the expression level of RKIP through immunohistochemistry and western blotting. Myometrial and leiomyoma cells were treated with locostatin to measure ECM expression by real time PCR, GSK3b expression by western blotting, cell migration by wound-healing assay and cell proliferation by MTT assay. We found that RKIP is expressed in human myometrial and leiomyoma tissue. Locostatin treatment resulted in the activation of the MAPK signal pathway (ERK phosphorylation), providing a powerful validation of our targeting protocol. Further, RKIP inhibition by locostatin reduces ECM components. Moreover, the inhibition of RKIP by locostatin impaired cell proliferation and migration in both leiomyoma and myometrial cells. Finally, locostatin treatment reduced GSK3β expression. Therefore, even if the activation of MAPK pathway should increase proliferation and migration, the destabilization of GSK3β leads to the reduction of proliferation and migration of myometrial and leiomyoma cells

TGF beta family members function in uterine healthy and fibrotic smooth muscle cells

Uterine leiomyomas are the most common benign tumors of fertile women and the most common indication for hysterectomy. Despite the high prevalence, significant health problems, and huge economical impact on the healthcare system, relatively little is understood about the etiology and pathophysiology of uterine leiomyoma (1). Consequently, medical treatments are still limited (2). The role of the growth factors as ultimate mediators of the steroids hormone is evident in the modulation of the cell proliferation and the morphological cells appearance (3). Activin-A and myostatin are growth factors belonging to TGF-β super family expressed and acting in myometrial (4,5) and leiomyoma cells (6) We aimed to explore the functions of activin and myostatin in human myometrial and leiomyoma cells. First we tested both Smad and non-Smad signaling pathways by western blot. We found that activin-A and myostatin can activate only Smad signaling pathway in both myometrial and leiomyoma cells. Next we explored the effect on cell proliferation and on fibrotic phenotype. We found that activin-A and myostatin are able to suppress primary myometrial cell proliferation but they cannot alter the proliferation of leiomyoma cells. In the next step, we found that activin-A can significantly increase fibronectin expression in leiomyoma cells. Those above results suggest that activin-A and myostatin may express antiproliferative and/or fibrotic effects depending on the cell types by activating Smad signaling pathway

Raf kinase inhibitor protein (RKIP) expression and function in uterine leiomyoma

I leiomiomi uterini (detti anche fibromi, miomi) sono tumori benigni che originano dallo strato muscolare dell’utero (miometrio) e rappresentano la principale indicazione dell’isterectomia nel mondo. I leiomiomi uterini colpiscono circa il 77% delle donne in eta fertile e circa il 25% di esse presenta tumori con sintomatologia clinica evidente, tra cui la presenza di forte o anomalo sanguinamento uterino, dolore o pressione pelvica, infertilità e aborti ricorrenti. È comunemente noto che questi tumori sono caratterizzati da una elevata proliferazione cellulare ed una eccessiva deposizione di matrice extracellulare (ECM). Si ritiene che la crescita dei leiomiomi dipenda dall’azione degli ormoni ovarici mediante elementi intermedi come citochine e fattori di crescita. La Proteina Inibitore della Raf Chinasi (RKIP) ha un ruolo emergente come regolatore in diversi pathway molecolari ed è associato a un numero crescente di malattie, essendo coinvolto indiverse vie di trasduzione del segnale. Lo scopo della presente tesi è stato quello di indagare la presenza e il ruolo dell’RKIP nel leiomioma. Abbiamo dimostrato che l’RKIP è espresso nel miometrio e nel leiomioma. Per individuare il ruolo dell’RKIP, abbiamo eseguito esperimenti in vitro con un composto chimico quale la locostatina, capace di legarsi all’RKIP bloccandolo. Abbiamo dimostrato che il trattamento con la locostatina porta all’attivazione della via di segnale MAPK (fosforilazione di ERK), fornendo una opportuna validazione dell’efficacia nel bloccare l’RKIP. Inoltre, abbiamo dimostrato che l'inibizione dell’RKIP con la locostatina riduce le componenti della ECM, tra cui il collagene 1A1, la fibronectina, e il versican. In aggiunta, l'inibizione dell’RKIP con la locostatina riduce la proliferazione cellulare e la migrazione sia nelle cellule miometriali che di leiomioma. Infine, abbiamo dimostrato che il trattamento con la locostatina riduce l’espressione del GSK3β. Pertanto, anche se l'attivazione delle MAPK dovrebbe far aumentare la proliferazione e la migrazione, la destabilizzazione e l’inattivazione del GSK3β porta alla riduzione della proliferazione e della migrazione delle cellule miometriali e di leiomioma.Uterine leiomyomas (fibroids, myomas) are benign (non-cancerous) tumors that origin from the smooth muscle layer of the uterus (myometrium), and are the most common indication for hysterectomy in the world. Uterine leiomyomas affect about 77% of women of reproductive-age, and approximately 25% of them bear clinically apparent tumors with symptoms like heavy or abnormal uterine bleeding, pelvic pain or pressure, infertility, and recurrent pregnancy loss. It is commonly known that these tumors are characterized by increased cell proliferation and excessive deposition of extracellular matrix (ECM). Growth of leiomyoma is thought to be dependent on ovarian hormones activity through intermediate elements such as cytokines and growth factors. Raf Kinase Protein Inhibitor (RKIP) has emerging roles as regulator of multiple signaling networks and is associated with an increasing number of diseases through its involvement with signal transduction pathways. The aim of the present thesis was to investigate the presence and the role of RKIP in leiomyoma. We demonstrated that RKIP is expressed in human myometrial and leiomyoma tissue. In order to define the RKIP role, we performed in vitro experiments with the chemical compound locostatin, known to bind and block RKIP. We showed that locostatin treatment results in the activation of the MAPK signal pathway (ERK phosphorylation), providing a powerful validation of our targeting protocol. Further, we showed that RKIP inhibition by locostatin reduces ECM components, including collagen1A1, fibronectin, and versican. Moreover, the inhibition of RKIP by locostatin impairs cell proliferation and migration in both leiomyoma and myometrial cells. Finally, we demonstrated that locostatin treatment reduced GSK3β expression. Therefore, even if the activation of MAPK pathway should increase proliferation and migration, the destabilization and inactivation of GSK3β leads to the reduction of proliferation and migration of myometrial and leiomyoma cells

Locostatin, a disrupter of Raf kinase inhibitor protein, inhibits extracellular matrix production, proliferation, and migration in human uterine leiomyoma and myometrial cells

Objective To investigate the presence of Raf kinase inhibitor protein (RKIP) in human myometrium and leiomyoma as well as to determine the effect of locostatin (RKIP inhibitor) on extracellular matrix (ECM) production, proliferation, and migration in human myometrial and leiomyoma cells. Design Laboratory study. Setting Human myometrium and leiomyoma. Patient(s) Thirty premenopausal women who were admitted to the hospital for myomectomy or hysterectomy. Intervention(s) Myometrial and leiomyoma tissues were used to investigate the localization and the expression level of RKIP through immunohistochemistry and Western blotting. Myometrial and leiomyoma cells were treated with locostatin (10 μM) to measure ECM expression by real-time polymerase chain reaction, GSK3β expression by Western blotting, cell migration by wound-healing assay, and cell proliferation by MTT assay and immunocytochemistry. Main Outcome Measure(s) The expression of RKIP in human myometrial and leiomyoma tissue; ECM components and GSK3β expression, migration, and proliferation in myometrial and leiomyoma cells. Result(s) RKIP is expressed in human myometrial and leiomyoma tissue. Locostatin treatment resulted in the activation of the mitogen-activated protein kinase (MAPK) signal pathway (ERK phosphorylation), providing a powerful validation of our targeting protocol. Further, RKIP inhibition by locostatin reduces ECM components. Moreover, the inhibition of RKIP by locostatin impaired cell proliferation and migration in both leiomyoma and myometrial cells. Finally, locostatin treatment reduced GSK3β expression. Therefore, even if the activation of MAPK pathway should increase proliferation and migration, the destabilization of GSK3β leads to the reduction of proliferation and migration of myometrial and leiomyoma cells. Conclusion(s) Our results indicate that RKIP may be involved in leiomyoma pathophysiology

Ulipristal acetate modulates the expression and functions of activin a in leiomyoma cells

Uterine leiomyoma is the most common benign gynecological tumor in women of reproductive age and represents the single most common indication for hysterectomy. A development of new treatments is necessary for a medical management, and in this direction, several hormonal drugs are under investigation. Ulipristal acetate (UPA; a selective progesterone receptor modulator) is considered as one of the most promising because progesterone has a critical role in development and growth of uterine leiomyoma. The effect of steroids is partly mediated by growth factors like activin A which increases extracellular matrix expression contributing to the growth of leiomyoma. The present study aimed to test whether UPA acts on leiomyoma cells affecting expression and functions of activin A system. Cultured myometrial and leiomyoma cells were treated with UPA, and messenger RNA (mRNA) expression levels of activin A (inhibin βA [INHBA] subunits), its binding proteins (follistatin [FST] and FST-related gene), and its receptors (activin receptor-like kinase 4 [ALK4], activin receptor type [ActR] II, and ActRIIB) were evaluated. The effect of UPA on activin A modulation of fibronectin and vascular endothelial growth factor A (VEGF-A) mRNA expression in cultured myometrial and leiomyoma cells was also studied. Ulipristal acetate decreased INHBA, FST, ActRIIB, and Alk4 mRNA expressions in leiomyoma cultured cells. In addition, UPA was able to block the activin A-induced increase in fibronectin or VEGF-A mRNA expression in myometrial and in leiomyoma cultured cells. The present data show that UPA inhibits activin A expression and functions in leiomyoma cells, and this may represent a possible mechanism of action of the drug on uterine leiomyoma

Traditional and Emerging Biomarkers in Asymptomatic Left Ventricular Dysfunction—Promising Non-Coding RNAs and Exosomes as Biomarkers in Early Phases of Cardiac Damage

Heart failure (HF) is one of the major causes of morbidity and mortality worldwide and represents an escalating problem for healthcare systems. The identification of asymptomatic patients with underlying cardiac subclinical disease would create an opportunity for early intervention and prevention of symptomatic HF. Traditional biomarkers are very useful as diagnostic and prognostic tools in the cardiovascular field; however, their application is usually limited to overt cardiac disease. On the other hand, a growing number of studies is investigating the diagnostic and prognostic potential of new biomarkers, such as micro-RNAs (miRNA), long non-coding RNAs, and exosome cargo, because of their involvement in the early phases of cardiac dysfunction. Unfortunately, their use in asymptomatic phases remains a distant goal. The aim of this review is to gather the current knowledge of old and novel biomarkers in the early diagnosis of cardiac dysfunction in asymptomatic individuals

Effects of SARS-CoV-2 on Cardiovascular System: The Dual Role of Angiotensin-Converting Enzyme 2 (ACE2) as the Virus Receptor and Homeostasis Regulator-Review

Angiotensin-converting enzyme 2 (ACE2) is the entry receptor for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the cause of Coronavirus Disease-2019 (COVID-19) in humans. ACE-2 is a type I transmembrane metallocarboxypeptidase expressed in vascular endothelial cells, alveolar type 2 lung epithelial cells, renal tubular epithelium, Leydig cells in testes and gastrointestinal tract. ACE2 mediates the interaction between host cells and SARS-CoV-2 spike (S) protein. However, ACE2 is not only a SARS-CoV-2 receptor, but it has also an important homeostatic function regulating renin-angiotensin system (RAS), which is pivotal for both the cardiovascular and immune systems. Therefore, ACE2 is the key link between SARS-CoV-2 infection, cardiovascular diseases (CVDs) and immune response. Susceptibility to SARS-CoV-2 seems to be tightly associated with ACE2 availability, which in turn is determined by genetics, age, gender and comorbidities. Severe COVID-19 is due to an uncontrolled and excessive immune response, which leads to acute respiratory distress syndrome (ARDS) and multi-organ failure. In spite of a lower ACE2 expression on cells surface, patients with CVDs have a higher COVID-19 mortality rate, which is likely driven by the imbalance between ADAM metallopeptidase domain 17 (ADAM17) protein (which is required for cleavage of ACE-2 ectodomain resulting in increased ACE2 shedding), and TMPRSS2 (which is required for spike glycoprotein priming). To date, ACE inhibitors and Angiotensin II Receptor Blockers (ARBs) treatment interruption in patients with chronic comorbidities appears unjustified. The rollout of COVID-19 vaccines provides opportunities to study the effects of different COVID-19 vaccines on ACE2 in patients on treatment with ACEi/ARB

Old and Novel Therapeutic Approaches in the Management of Hyperglycemia, an Important Risk Factor for Atherosclerosis

Hyperglycemia is considered one of the main risk factors for atherosclerosis, since high glucose levels trigger multiple pathological processes, such as oxidative stress and hyperproduction of pro-inflammatory mediators, leading to endothelial dysfunction. In this context, recently approved drugs, such as glucagon-like-peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2i), could be considered a powerful tool for to reduce glucose concentration and cardiovascular risk. Interestingly, many patients with type 2 diabetes mellitus (T2DM) and insulin resistance have been found to be deficient in vitamin D. Recent studies pointed out the unfavorable prognostic values of T2DM and vitamin D deficiency in patients with cardiac dysfunction, either when considered individually or together, which shed light on the role of vitamin D in general health status. New evidence suggests that SGLT2i could adversely affect the production of vitamin D, thereby increasing the risk of fractures, which are common in patients with T2DM. Therefore, given the biological effects of vitamin D as an anti-inflammatory mediator and a regulator of endothelial function and calcium equilibrium, these new findings should be taken into consideration as well. The aim of this review is to gather the latest advancements regarding the use of antidiabetic and antiplatelet drugs coupled with vitamin D supplementation to control glucose levels, therefore reducing the risk of coronary artery disease (CAD)

Growth factors and pathogenesis

Growth factors are relatively small and stable, secreted or membrane-bound polypeptide ligands, which play an important role in proliferation, differentiation, angiogenesis, survival, inflammation, and tissue repair, or fibrosis. They exert multiple effects through the activation of signal transduction pathways by binding to their receptors on the surface of target cells. A number of studies have demonstrated the central role of growth factors and their signaling pathways in the pathogenesis of uterine leiomyomas. Numerous differentially expressed growth factors have been identified in leiomyoma and myometrial cells. These growth factors can activate multiple signaling pathways (Smad 2/3, ERK 1/2, PI3K, and β-catenin) and regulate major cellular processes, including inflammation, proliferation, angiogenesis, and fibrosis which are linked to uterine leiomyoma development and growth. In this chapter, we discuss the role of growth factors and their signaling pathways in the pathogenesis of uterine leiomyomas