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Radiation-Induced Cardiac Remodeling: Mechanisms and Therapeutic Approaches. 辐射诱导的心脏重构:机制和治疗方法。
IF 3.4 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-07-01 Epub Date: 2025-05-29 DOI: 10.1007/s12012-025-10006-6
Zahraa Sabah Ghnim, Ayat Hussein Adhab, Morug Salih Mahdi, Ashishkumar Kyada, R Roopashree, Vishal Thakur, Manpreet Kaur, Anirudh Gupta, Aseel Salah Mansoor, Usama Kadem Radi, Nasr Saadoun Abd, Munther Kadhim

Radiation-induced cardiac remodeling (RICR) is one of the complications of exposure to radiotherapy. These disorders may occur for a subset of cancer patients, when the heart remains in part or in full in the radiation field. Despite advancements in radiotherapy techniques, cardiotoxicity has remained a concern after radiotherapy. RICR includes complex pathophysiological processes, which can be initiated by oxidative stress and cardiomyocyte cell death and continue with inflammation, arrhythmia, vascular and valvular abnormalities, and fibrosis, collectively contributing to structural and functional changes in the heart. Some studies have suggested strategies for RICR encompass pharmacological interventions, including angiotensin-converting enzyme (ACE) inhibitors, natural products, antioxidants, and others, which aim to mitigate cardiac damage and improve outcomes. Advanced therapies, including stem cell and gene therapy, as well as some adjuvants and novel drugs targeting specific molecular pathways, represent future directions for treatment. This review aims to elucidate the mechanisms underlying RICR, highlight early detection strategies, and discuss current and emerging therapeutic approaches.

辐射诱发的心脏重构(RICR)是放射治疗的并发症之一。这些疾病可能发生在一部分癌症患者身上,当心脏部分或全部处于辐射场中时。尽管放射治疗技术取得了进步,但放射治疗后的心脏毒性仍然是一个令人担忧的问题。RICR包括复杂的病理生理过程,可由氧化应激和心肌细胞死亡引发,并伴随炎症、心律失常、血管和瓣膜异常以及纤维化,共同导致心脏的结构和功能改变。一些研究表明,RICR的治疗策略包括药物干预,包括血管紧张素转换酶(ACE)抑制剂、天然产物、抗氧化剂等,旨在减轻心脏损伤并改善预后。先进的治疗方法,包括干细胞和基因治疗,以及一些佐剂和针对特定分子途径的新药,代表了未来的治疗方向。本综述旨在阐明RICR的机制,强调早期发现策略,并讨论当前和新兴的治疗方法。
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引用次数: 0
Systemic Inflammation Mediates the Association Between Blood Trihalomethane Concentrations and Cardiovascular Disease in U.S. Individuals Over 45: Insights from NHANES 2005-2012. 系统性炎症介导美国45岁以上人群血液三卤甲烷浓度与心血管疾病之间的关系:来自NHANES 2005-2012的见解
IF 3.4 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-07-01 Epub Date: 2025-05-14 DOI: 10.1007/s12012-025-10008-4
Songfeng Zhao, Hongyi Liu, Hailong Zhong, Yongkai Qin, Jiayue Duan, Aihua Liu

Trihalomethanes (THMs), the major byproducts of water chlorination which are associated with various adverse health outcomes. However, the relationship of THMs with cardiovascular disease (CVD) in aging populations remains underexplored. We analyzed data from 5,400 participants in the National Health and Nutrition Examination Survey (NHANES) 2005-2012. Associations between blood THM concentrations and CVD were evaluated using weighted multivariable logistic regression. Weighted quantile sum (WQS) regression was applied to identify the most relevant THM components. We also performed mediation analysis to evaluate the role of inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), white blood cell count (WBC), and systemic inflammation response index (SIRI). Network toxicology analysis was used to explore the biological pathways linking THM exposure, CVD, and aging. Elevated blood concentrations of THMs, particularly chloroform (TCM) and total THMs (TTHMs), were significantly associated with increased odds of CVD. Stratified analyses revealed stronger associations among older adults, males, individuals with higher BMI, and those with hypertension. WQS regression identified TCM as the predominant contributor to the THM-CVD association, accounting for 58.0% of the mixture's effect. Mediation analysis showed that NLR partially mediated the association between TTHMs and CVD, explaining 7.12% of the total effect. Network toxicology analysis highlighted inflammation-related pathways, including the IL-17 signaling pathway, as key mechanisms linking THM exposure, CVD, and aging. Our study revealed elevated blood TCM and TTHM concentrations are associated with increased prevalence of CVD among U.S. adults aged 45 years and older. Network toxicology and mediation analysis suggest that systemic inflammation may play a mediating role in this relationship.

三卤甲烷(THMs),水氯化的主要副产品,与各种不利的健康后果有关。然而,THMs与老年人群心血管疾病(CVD)的关系仍未得到充分探讨。我们分析了2005-2012年国家健康与营养检查调查(NHANES)的5400名参与者的数据。采用加权多变量logistic回归评估血THM浓度与CVD之间的关系。采用加权分位数和(WQS)回归识别最相关的THM成分。我们还进行了中介分析,以评估炎症标志物的作用,包括中性粒细胞与淋巴细胞比率(NLR)、白细胞计数(WBC)和全身炎症反应指数(SIRI)。网络毒理学分析用于探索THM暴露,CVD和衰老之间的生物学途径。血液中THMs浓度升高,特别是氯仿(TCM)和总THMs (TTHMs),与心血管疾病的发病率增加显著相关。分层分析显示,老年人、男性、BMI较高的个体和高血压患者之间的相关性更强。WQS回归发现中药是THM-CVD关联的主要贡献者,占混合物效应的58.0%。中介分析显示,NLR部分介导了TTHMs与CVD之间的关联,解释了总效应的7.12%。网络毒理学分析强调炎症相关通路,包括IL-17信号通路,是连接THM暴露、CVD和衰老的关键机制。我们的研究表明,在美国45岁及以上的成年人中,血液中草药和TTHM浓度升高与心血管疾病患病率增加有关。网络毒理学和中介分析表明,全身性炎症可能在这种关系中起中介作用。
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引用次数: 0
Biomarkers Related to Interferon-γ Pathway in Myocardial Ischemia-Reperfusion Injury and the Potential Molecular Mechanisms. 心肌缺血再灌注损伤中与干扰素γ通路相关的生物标志物及其潜在的分子机制。
IF 3.4 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-07-01 Epub Date: 2025-05-09 DOI: 10.1007/s12012-025-09999-x
Fang Jia, Wei Jiang, Yan Zhang, Lisha Zhang, Tuo Han, Danmeng Liu, Jiahong Xue, Fuxue Deng

Although reperfusion therapy can reduce the mortality of myocardial infarction, it results in myocardial ischemia-reperfusion injury (MIRI). The molecular mechanism by which the interferon-γ pathway affects MIRI is unclear, so we addressed this problem by mining transcriptome and single-cell sequencing data. The GSE160516 and GSE83472 datasets, single cell RNA sequencing (scRNA-seq) data of GSE227088 dataset and 182 interferon-γ pathway related genes (IRGs) were retrieved and incorporated into this study. The differentially expressed genes (DEGs) between MIRI and control samples were searched, the candidate genes were obtained by intersecting DEGs with IRGs. The protein-protein interaction (PPI) analysis was utilized for selecting key genes from candidate genes. Moreover, key genes with significant expression and consistent trend in GSE160516 and GSE83472 datasets were selected as biomarkers. The biological functions and regulatory mechanism of biomarkers were investigated by enrichment analysis and predicting the upstream molecules targeting them. Ulteriorly, cell clusters were identified via unsupervised cluster analysis and merged into different cell types by cell annotation. Cell types in which biomarkers observably and differentially expressed were selected as crucial cell types. Finally, cell communication and pseudo-time analysis were implemented based on crucial cell types. Totally 34 candidate genes were searched by overlapping 1,930 DEGs with 182 IRGs. Nine key genes were singled out from candidate genes, of which Myd88 and Trp53 were significantly upregulated in the MIRI samples of GSE160516 and GSE83472 datasets, so they were identified as biomarkers. Besides, they participated in pathways such as ribosome, spliceosome and cell cycle. Myd88 might be simultaneously regulated by mmu-miR-361-3p and mmu-miR-421-3p, and Trp53 could be regulated by Abl1 and Tead2. Totally 25 cell clusters were merged into six cell types, of which three crucial cell types (cardiomyocyte, fibroblast, and macrophage) could interact with each other through receptor-ligand. Pseudo-time analysis revealed states 1, 2, and 5 of macrophages might be associated with MIRI. Two biomarkers (Myd88 and Trp53) related to IRGs in MIRI were mined, providing a reference for elucidating the mechanism of interferon-γ pathway on MIRI.

再灌注治疗虽能降低心肌梗死死亡率,但可导致心肌缺血-再灌注损伤(MIRI)。干扰素-γ通路影响MIRI的分子机制尚不清楚,因此我们通过挖掘转录组和单细胞测序数据来解决这个问题。检索GSE160516和GSE83472数据集、GSE227088数据集的单细胞RNA测序(scRNA-seq)数据和182个干扰素-γ通路相关基因(IRGs)并纳入本研究。搜索MIRI与对照样本之间的差异表达基因(DEGs),将DEGs与IRGs相交获得候选基因。利用蛋白-蛋白相互作用(PPI)分析从候选基因中筛选出关键基因。选择GSE160516和GSE83472数据集中表达显著且趋势一致的关键基因作为生物标志物。通过富集分析和上游靶向分子预测,研究了生物标志物的生物学功能和调控机制。最后,通过无监督聚类分析识别细胞簇,并通过细胞注释将其合并为不同的细胞类型。选择生物标志物可观察和差异表达的细胞类型作为关键细胞类型。最后,基于关键细胞类型实现细胞通信和伪时间分析。通过1930个deg与182个irg的重叠,共搜索到34个候选基因。从候选基因中筛选出9个关键基因,其中Myd88和Trp53在GSE160516和GSE83472数据集的MIRI样本中显著上调,因此被鉴定为生物标志物。此外,它们还参与核糖体、剪接体、细胞周期等途径。Myd88可能同时受到mmu-miR-361-3p和mmu-miR-421-3p的调控,Trp53可能受到Abl1和Tead2的调控。共将25个细胞簇合并为6种细胞类型,其中3种关键细胞类型(心肌细胞、成纤维细胞和巨噬细胞)可以通过受体配体相互作用。伪时间分析显示巨噬细胞状态1、2和5可能与MIRI有关。挖掘MIRI中与IRGs相关的两个生物标志物(Myd88和Trp53),为阐明干扰素-γ通路在MIRI中的作用机制提供参考。
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引用次数: 0
Distinct Features of Proton-Induced X-ray Emission (PIXE) and Inductively Coupled Plasma Mass Spectrometry (ICP-MS) When Used for Elemental Analysis of Nail Samples. 质子诱导x射线发射(PIXE)和电感耦合等离子体质谱(ICP-MS)用于指甲样品元素分析的不同特征。
IF 3.4 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-07-01 Epub Date: 2025-05-16 DOI: 10.1007/s12012-025-10011-9
Kristina M Zierold, Melissa J Smith, Jason Xu, Lu Cai, Lonnie Sears

Biomarkers, such as toenails, are commonly used to investigate the health status of individuals. Nails samples are a useful marker of exposure, as they are easy to collect, store, and represent exposure from 6 to 12 months. There are multiple analytical methods that can be used to extract long-term exposure profiles from toenails including Proton-Induced X-Ray Emission(PIXE) and Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The overall goal of this research was to evaluate the level of agreement between the two analytical methods for assessment of different metals in nail samples. Children's nail samples were collected. Nail samples were first analyzed by PIXE and then analyzed by ICP-MS. To compute quantiles for the metal concentrations that had some fully observed and some left-censored concentrations, a reverse Kaplan-Meier estimator was used. Lin's concordance correlation coefficient (CCC) and the Pearson correlation coefficient were calculated to assess agreement between the two methods and to determine the strength of the linear association between the metal concentration measurements obtained under each analytical technique. PIXE and ICP-MS determined similar median concentrations for calcium, copper, potassium, and nickel. However, there were stark differences between other elements. Several elements, such as copper, potassium, and zinc represented strong concordance through use of the CCC. In many studies, scholars want to evaluate how well one measurement can reproduce another, and our paper used several elements to show the degree of reproducibility between the two analytical methods. This can be useful when scholars are determining methods to assess biomarkers in health-related studies.

生物标志物,如脚趾甲,通常用于调查个人的健康状况。指甲样本是一种有用的暴露标记,因为它们易于收集、储存,并代表6至12个月的暴露。有多种分析方法可用于提取趾甲的长期暴露谱,包括质子诱导x射线发射(PIXE)和电感耦合等离子体质谱(ICP-MS)。本研究的总体目标是评估两种分析方法之间的协议水平,以评估指甲样品中的不同金属。收集儿童指甲样本。指甲样品先用PIXE分析,再用ICP-MS分析。为了计算一些完全观察到的和一些左删减浓度的金属浓度的分位数,使用了反向Kaplan-Meier估计器。计算Lin’s一致性相关系数(CCC)和Pearson相关系数,以评估两种分析方法之间的一致性,并确定每种分析技术下获得的金属浓度测量值之间的线性关联强度。PIXE和ICP-MS测定的钙、铜、钾和镍的中位浓度相似。然而,其他元素之间存在着明显的差异。一些元素,如铜、钾和锌,通过使用CCC表现出很强的一致性。在许多研究中,学者们想要评估一种测量方法如何很好地再现另一种测量方法,我们的论文使用了几个元素来显示两种分析方法之间的可重复性程度。当学者们在确定与健康相关的研究中评估生物标志物的方法时,这可能是有用的。
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引用次数: 0
Associations Between Metal-Metal Interaction and the Risk of Hypertension: A Case-Control Study in Chinese Community-Dwelling Elderly. 金属-金属相互作用与高血压风险的关系:中国社区老年人病例对照研究
IF 3.4 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-07-01 Epub Date: 2025-05-28 DOI: 10.1007/s12012-025-10015-5
Meiyan Li, Yihong Di, Siyu Duan, Rui Wang, Pei He, Zhongyuan Zhang, Yuqing Dai, Zhuoheng Shen, Yue Chen, Huifang Yang, Xiaoyu Li, Jian Sun, Rui Zhang

Fewer studies have focused on the interaction of metal mixtures with hypertension, especially in Chinese community-dwelling elderly. In addition, the relationship between metal exposure and hypertension may be attenuated or strengthened by the presence of multiple chronic diseases in older adults. In this study, inductively coupled plasma mass spectrometry was used to detect the levels of 12 metals in the urine of 693 elderly people in the Yinchuan community. We employed Directed Acyclic Graphs (DAG) to select variables for adjustment in the model. Conditional logistic regression model and restricted cubic spline analysis (RCS) were used to explore the association between and dose-response relationship between metal concentrations in urine and hypertension. Quantile g-computation and Bayesian kernel machine regression (BKMR) to analyze the association of individual urinary metal concentrations and metal mixtures with hypertension risk. Urinary concentrations of 12 metals (vanadium, iron, cobalt, zinc, copper, arsenic, selenium, molybdenum, cadmium, tellurium, thallium, and lead) were higher in the hypertension group than in the non-hypertension group. In the RCS models, the urinary concentrations of vanadium, iron, and lead showed a linear dose-response relationship with hypertension risk. Quantile g-computation analyses showed cadmium contributed the largest positive weights. The BKMR models showed that the positive slope of lead became steep at higher concentrations of urinary iron when the other three metals were at the median. We found that exposure to metal mixtures was associated with the risk of hypertension and a significant positive interaction between urinary iron and lead. Further research is needed to confirm our findings and elucidate the underlying mechanisms of the interaction between metals and hypertension.

很少有研究关注金属混合物与高血压的相互作用,特别是在中国社区老年人中。此外,金属暴露与高血压之间的关系可能因老年人存在多种慢性疾病而减弱或加强。本研究采用电感耦合等离子体质谱法对银川社区693名老年人尿液中的12种金属进行了检测。我们使用有向无环图(DAG)来选择模型中需要调整的变量。采用条件logistic回归模型和限制性三次样条分析(RCS)探讨尿中金属浓度与高血压的相关性和剂量-反应关系。分位数g计算和贝叶斯核机回归(BKMR)分析个体尿金属浓度和金属混合物与高血压风险的关系。高血压组尿液中12种金属(钒、铁、钴、锌、铜、砷、硒、钼、镉、碲、铊和铅)的浓度高于非高血压组。在RCS模型中,尿中钒、铁和铅的浓度与高血压风险呈线性剂量反应关系。分位数g计算分析显示,镉贡献了最大的正权重。BKMR模型显示,当其他三种金属处于中值时,铅的正斜率在尿铁浓度较高时变得陡峭。我们发现,接触金属混合物与高血压的风险有关,并且尿铁和铅之间存在显著的正相互作用。需要进一步的研究来证实我们的发现,并阐明金属与高血压之间相互作用的潜在机制。
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引用次数: 0
Cardio-Metabolic Effects of Nickel: A Narrative Review. 镍的心脏代谢作用:一个叙述性的回顾。
IF 3.7 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-07-01 Epub Date: 2025-06-01 DOI: 10.1007/s12012-025-10014-6
Yucheng Liu, Xiaomin Luo, Yongde Peng, Lu Cai

Nickel, a transition metal, is ubiquitous in the environment due to both natural processes and anthropogenic activities. While exposure to nickel has been linked to various adverse health outcomes-including genomic damage, allergic reactions, renal disorders, pulmonary fibrosis, carcinomas of the lung and nasal cavities-its cardiovascular toxicity and metabolic implications remain comparatively underexplored. Recently, a series of cross-sectional analyses utilizing data from the National Health and Nutrition Examination Survey (NHANES) have emerged, providing valuable insights into this issue. Based on the literature from PubMed, this review aims to comprehensively, but narratively summarize clinical observations and database analyses derived from human survey datasets, alongside experimental studies conducted on animal models exposed to varying doses of nickel. Current literature suggests a potential association between nickel exposure, primarily indicated by urinary nickel levels, and cardiovascular as well as metabolic disease variables; however, at low doses, inconclusive findings remain even using the same databases, mainly due to the clinical variables differently used in different studies. Experimental research has demonstrated significant toxic effects of exposure to nickel across multiple organs, including the heart and liver, which seemed significantly associated with oxidative stress and damage. Consequently, this review underscores the urgent need for further investigation utilizing both human data and experimental animal models, particularly focusing on low-level nickel exposure, to elucidate the cardiovascular and metabolic consequences of nickel exposure in humans.

镍是一种过渡金属,由于自然过程和人为活动,镍在环境中无处不在。虽然接触镍与各种不良健康结果有关,包括基因组损伤、过敏反应、肾脏疾病、肺纤维化、肺癌和鼻腔癌,但其心血管毒性和代谢影响仍未得到充分研究。最近,利用国家健康和营养检查调查(NHANES)数据的一系列横断面分析已经出现,为这个问题提供了有价值的见解。基于PubMed的文献,本综述旨在全面但叙述性地总结临床观察和来自人类调查数据集的数据库分析,以及对暴露于不同剂量镍的动物模型进行的实验研究。目前的文献表明,镍暴露(主要通过尿镍水平显示)与心血管和代谢疾病变量之间存在潜在关联;然而,在低剂量下,即使使用相同的数据库,仍存在不确定的结果,这主要是由于不同研究中使用的临床变量不同。实验研究表明,接触镍会对包括心脏和肝脏在内的多个器官产生显著的毒性作用,这似乎与氧化应激和损伤有显著关联。因此,本综述强调迫切需要利用人类数据和实验动物模型进行进一步研究,特别是关注低水平镍暴露,以阐明镍暴露对人类心血管和代谢的影响。
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引用次数: 0
Association Between Urinary Metals and Polycyclic Aromatic Hydrocarbon Levels and Cardiovascular Disease Among Adult Americans: Data from NHANES 2011 to 2016. 美国成年人尿中金属和多环芳烃水平与心血管疾病的关系:NHANES 2011 - 2016数据
IF 3.4 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-07-01 Epub Date: 2025-05-27 DOI: 10.1007/s12012-025-10009-3
Minyao Zhao, Sijie Gu, Tingchao Liu, Shipeng Gao, Zheng Qiao, Kui Wang, Qiang Niu, Rulin Ma, Heng Guo, Shuxia Guo, Jia He

Previous studies have inconclusively examined the associations of metals or polycyclic aromatic hydrocarbons (PAHs) with cardiovascular disease (CVD) separately, highlighting the need to explore their combined association with CVD. Based on the 2011-2016 National Health and Nutrition Examination Survey, the association of 12 metals and six PAHs in urine with CVD was analyzed using weighted logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR). Crucial metals and PAHs were screened, and dose-response, subgroup, interactions, and mediation analyses were conducted. 4306 participants were included, of whom 406 had CVD. Weighted logistic regression showed that cadmium (OR = 1.41, 95% CI 1.11-1.78), tin (OR = 1.63, 95% CI 1.03-2.60), and 1-hydroxypyrene (1-PYR) (OR = 1.40, 95% CI 1.15-1.69) were positively correlated with CVD. These factors also showed a linear relation with CVD. The WQS and BKMR models indicated that the combined association of 12 metals and six PAHs was positively associated with CVD. Cadmium, cesium, tin, uranium, and 1-PYR played critical roles (all weights > 0.050). Subgroup analysis revealed that these substances were mostly positively associated with CVD in young and middle-aged people, smokers, drinkers, and those who were overweight. There was an interaction between tin and smoking status (P for interaction < 0.05). Cadmium and tin mediated 18.40% and 6.90% of the association of 1-PYR with CVD, respectively, whereas the proportions of the mediating effects of 1-PYR in the association of cadmium and tin with CVD were 8.10% and 7.90%, respectively. Overall, higher levels of urinary metals and PAHs mixtures may be associated with higher CVD prevalence. Cadmium, cesium, tin, uranium, and 1-PYR played crucial roles in this association. Cadmium and tin played mediating roles in the association between 1-PYR and CVD. Meanwhile, 1-PYR also played a mediating role in the association between cadmium and tin and CVD.

先前的研究单独考察了金属或多环芳烃(PAHs)与心血管疾病(CVD)的关系,但没有得出结论,因此需要探索它们与CVD的联合关系。基于2011-2016年全国健康与营养调查,采用加权logistic回归、加权分位数和(WQS)回归和贝叶斯核机回归(BKMR)分析尿中12种金属和6种多环芳烃与心血管疾病的关系。筛选了关键金属和多环芳烃,并进行了剂量反应、亚群、相互作用和中介分析。纳入4306名参与者,其中406名患有心血管疾病。加权logistic回归显示,镉(OR = 1.41, 95% CI 1.11-1.78)、锡(OR = 1.63, 95% CI 1.03-2.60)和1-羟基芘(1-PYR) (OR = 1.40, 95% CI 1.15-1.69)与心血管疾病呈正相关。这些因素也与CVD呈线性关系。WQS和BKMR模型表明,12种金属与6种多环芳烃的联合与CVD呈正相关。镉、铯、锡、铀和1-PYR起关键作用(重量均为100 - 0.050)。亚组分析显示,这些物质与中青年、吸烟者、饮酒者和超重者的心血管疾病呈正相关。锡与吸烟状态之间存在相互作用(P为相互作用)
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引用次数: 0
Impact of Proton Pump Inhibitors on Osimertinib-Induced Cardiotoxicity in NSCLC Patients. 质子泵抑制剂对非小细胞肺癌患者奥西替尼诱导的心脏毒性的影响。
IF 3.4 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-07-01 Epub Date: 2025-05-09 DOI: 10.1007/s12012-025-10012-8
Haitao Wang, Sinan Ma, Weijia Huang, Keyu Chen, Jiao Xie, Na Wang, Youjia Li, Qianting Yang, Xin Yang, Yan Wang

There is a lack of comprehensive research investigating the relationship between proton pump inhibitors (PPIs) and osimertinib combination therapy concerning cardiotoxicity. We conducted a retrospective analysis of adverse event reports from the US Food and Drug Administration Adverse Event Reporting System (FAERS). In this analysis, we used patients with non-small cell lung cancer (NSCLC) who did not receive osimertinib or PPIs as a control group to assess the association between cardiotoxicity occurrence in patients receiving osimertinib with PPIs and those without PPIs. We employed disproportionality analysis along with both additive and multiplicative models. The reporting odds ratios (ROR) for cardiac events, including torsade de pointes/QT prolongation, cardiomyopathy, cardiac arrhythmias, cardiac failure, ischaemic heart disease, and embolic and thrombotic events, were significantly higher in patients using PPIs with osimertinib (14.11, 9.04-22.04; 4.67, 2.67-8.16; 4.43, 3.17-6.20; 3.67, 2.53-5.34; 2.24, 1.31-3.84; 1.92, 1.43-2.56, respectively) compared to osimertinib alone (4.87, 3.91-6.07; 2.50, 2.02-3.09; 1.59, 1.37-1.84; 2.00, 1.74-2.29; 0.65, 0.50-0.84; 1.01, 0.91-1.11). Our investigation unveiled an elevated risk of cardiotoxicity in NSCLC patients when osimertinib was combined with PPIs, compared to osimertinib monotherapy. Therefore, vigilant monitoring for cardiotoxicity is paramount in NSCLC patients undergoing these combined treatments.

关于质子泵抑制剂(PPIs)与奥西替尼联合治疗对心脏毒性的影响,目前还缺乏全面的研究。我们对来自美国食品和药物管理局不良事件报告系统(FAERS)的不良事件报告进行了回顾性分析。在本分析中,我们使用未接受奥西替尼或质子泵抑制剂治疗的非小细胞肺癌(NSCLC)患者作为对照组,以评估接受奥西替尼合并质子泵抑制剂和未接受质子泵抑制剂治疗的患者心脏毒性发生之间的关系。我们采用歧化分析以及加法和乘法模型。心脏事件的报告优势比(ROR),包括点扭转/QT间期延长、心肌病、心律失常、心力衰竭、缺血性心脏病、栓塞和血栓事件,在使用奥西替尼的PPIs患者中显著更高(14.11,9.04-22.04;4.67, 2.67 - -8.16;4.43, 3.17 - -6.20;3.67, 2.53 - -5.34;2.24, 1.31 - -3.84;1.92, 1.43-2.56),与单独使用奥西替尼相比(4.87,3.91-6.07;2.50, 2.02 - -3.09;1.59, 1.37 - -1.84;2.00, 1.74 - -2.29;0.65, 0.50 - -0.84;1.01, 0.91 - -1.11)。我们的研究显示,与奥希替尼单药治疗相比,奥希替尼联合PPIs治疗非小细胞肺癌患者的心脏毒性风险增加。因此,在接受这些联合治疗的非小细胞肺癌患者中,警惕监测心脏毒性是至关重要的。
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引用次数: 0
Shen-fu Injection Modulates HIF- 1α/BNIP3-Mediated Mitophagy to Alleviate Myocardial Ischemia-Reperfusion Injury. 参附注射液调节HIF- 1α/ bnip3介导的线粒体自噬减轻心肌缺血再灌注损伤
IF 3.4 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-06-01 Epub Date: 2025-04-17 DOI: 10.1007/s12012-025-09993-3
Zhian Chen, Tianying Liu, Lihui Xiong, Zhi Liu

Coronary reperfusion therapy is the most common surgical treatment for myocardial infarction, but it can further induce myocardial ischemia-reperfusion injury (MIRI). Therefore, MIRI following coronary intervention is a challenging clinical issue. This study aims to investigate the involvement of HIF- 1α/BNIP3-mediated mitophagy in the protective effects of Shen-fu Injection (SFI) on MIRI in rats. Key targets and signaling pathways of myocardial MIRI were analyzed using high-throughput transcriptome data from the GSE240842 dataset in the GEO database.To establish the MIRI rat model, the left anterior descending coronary artery was ligated for 30 min, followed by reperfusion for 120 min. Hypoxia/reoxygenation (H/R) in neonatal rat primary cardiomyocytes was induced by oxygen-glucose deprivation for 4 h, followed by reoxygenation for 2 h. Two hours after reperfusion, assessments included myocardial infarction area, CK-MB, CTnI, HE staining, TUNEL, mitochondrial ultrastructure and autophagosomes, HIF- 1α, BNIP3, LC3B-II, LC3B-I protein expression, immunofluorescence, and qRT-PCR. Cardiac function was also evaluated using M-mode ultrasound 2 h after reperfusion. In cardiomyocytes, CCK- 8, EdU cell proliferation levels, scratch assay, mitochondrial membrane potential, ROS levels, cardiomyocyte apoptosis, protein expression levels, and immunofluorescence were assessed 2 h after reoxygenation. Our results indicate that HIF- 1α and BNIP3 are key targets in MIRI. SFI upregulates HIF- 1α expression, promoting moderate mitophagy. This process clears excessively damaged mitochondria, reduces cardiomyocyte apoptosis, and decreases myocardial injury. Additionally, SFI reduces autophagosome accumulation, lowers ROS production, and stabilizes membrane potential. Consequently, the area of myocardial infarction is reduced, and cardiac function is improved. SFI activates the HIF- 1α/BNIP3 pathway to mediate moderate mitophagy, effectively reducing cardiomyocyte apoptosis and alleviating myocardial ischemia-reperfusion injury, thereby protecting cardiomyocytes.

冠状动脉再灌注治疗是心肌梗死最常用的手术治疗方法,但其可进一步诱发心肌缺血再灌注损伤(MIRI)。因此,冠状动脉介入治疗后的MIRI是一个具有挑战性的临床问题。本研究旨在探讨HIF- 1α/ bniip3介导的线粒体自噬参与参附注射液(SFI)对大鼠MIRI的保护作用。使用GEO数据库中GSE240842数据集的高通量转录组数据分析心肌MIRI的关键靶点和信号通路。建立MIRI大鼠模型,结扎左冠状动脉前降支30 min,再灌注120 min,氧糖剥夺4 H,再灌注2 H诱导新生大鼠原代心肌细胞缺氧/再氧合(H/R)。再灌注2 H后,评估心肌梗死面积、CK-MB、CTnI、HE染色、TUNEL、线粒体超微结构和自噬体、HIF- 1α、BNIP3、LC3B-II、LC3B-I蛋白表达、免疫荧光和qRT-PCR。再灌注2 h后用m型超声评价心功能。在心肌细胞中,再氧化2 h后,检测CCK- 8、EdU细胞增殖水平、划痕试验、线粒体膜电位、ROS水平、心肌细胞凋亡、蛋白表达水平和免疫荧光。我们的研究结果表明HIF- 1α和BNIP3是MIRI的关键靶点。SFI上调HIF- 1α表达,促进适度的线粒体自噬。这个过程清除过度受损的线粒体,减少心肌细胞凋亡,减少心肌损伤。此外,SFI可以减少自噬体的积累,降低ROS的产生,并稳定膜电位。从而减少心肌梗死面积,改善心功能。SFI激活HIF- 1α/BNIP3通路,介导中度线粒体自噬,有效减少心肌细胞凋亡,减轻心肌缺血再灌注损伤,从而保护心肌细胞。
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引用次数: 0
Membrane Protein of SARS-CoV-2 Promotes the Production of CXCL10 and Apoptosis of Myocardial Cells. SARS-CoV-2膜蛋白促进心肌细胞CXCL10的产生和凋亡
IF 3.4 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-06-01 Epub Date: 2025-04-28 DOI: 10.1007/s12012-025-10001-x
Xiaoguang Wu, Lu Tang, Wen Huang, Min Gao, Changhao Xu, Peng Li, Xiangqing Kong

SARS-CoV-2 infections directly or indirectly cause unconscionable vascular events, significantly increasing the morbidity and mortality of COVID-19. Biomarkers associated with cardiac injury often elevate in individuals with COVID-19. Cytokine storm is a mechanism underlying myocardial cell injury caused by SARS-CoV-2 infections. Cell apoptosis in AC16 cells overexpressing structural and helper proteins of SARS-CoV-2 was detected by Western blot, MTT and TUNEL assay. The M protein was determined to play the most pronounced role in inducing apoptosis. Transcriptome sequencing on AC16 cells overexpressing the M protein was performed to screen differentially expressed genes (DEGs), which were further subjected to the gene set enrichment analysis. The regulatory effect of CXCL10 on cell apoptosis of AC16 cells overexpressing M protein was finally explored. Overexpression of M protein significantly increased the Bax/Bcl-2 and cleaved caspase-3/caspase-3(CC3/C3) ratios and the percentage of TUNEL-positive cells in AC16 cells, while markedly reducing cell viability. CXCL10 was the most prominent DEG in AC16 cells overexpressing M protein. Knockdown of CXCL10 partially reversed the increases in the Bax/Bcl-2 and cleaved caspase-3/caspase-3 ratios, the percentage of TUNEL-positive cells, as well as the release of pro-inflammatory cytokines in AC16 cells overexpressing M protein. The M protein of SARS-CoV-2 triggers the production of CXCL10 and apoptosis of myocardial cells.

SARS-CoV-2感染直接或间接引起不合理的血管事件,显著增加COVID-19的发病率和死亡率。与心脏损伤相关的生物标志物在COVID-19患者中经常升高。细胞因子风暴是SARS-CoV-2感染引起心肌细胞损伤的机制之一。Western blot、MTT和TUNEL检测过表达SARS-CoV-2结构蛋白和辅助蛋白的AC16细胞的细胞凋亡情况。M蛋白在诱导细胞凋亡中起着最显著的作用。对过表达M蛋白的AC16细胞进行转录组测序,筛选差异表达基因(deg),并进一步进行基因集富集分析。最后探讨CXCL10对过表达M蛋白的AC16细胞凋亡的调控作用。M蛋白过表达显著提高AC16细胞中Bax/Bcl-2和cleaved caspase-3/caspase-3(CC3/C3)比值及tunel阳性细胞百分比,同时显著降低细胞活力。在M蛋白过表达的AC16细胞中,CXCL10是最显著的DEG。CXCL10的下调部分逆转了过表达M蛋白的AC16细胞中Bax/Bcl-2和cleaved caspase-3/caspase-3比值的升高、tunel阳性细胞的百分比以及促炎细胞因子的释放。SARS-CoV-2的M蛋白触发CXCL10的产生和心肌细胞的凋亡。
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引用次数: 0
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Cardiovascular Toxicology
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