In the course of this study, several endogenous compounds and model substances were used to mimic the conditions in patients suffering from hypertension. As endogenous compounds, angiotensin II and aldosterone were chosen. As model substances, 4-nitroquinoline-1-oxide (NQO), hydrogen peroxide and phorbol 12-myristate 13-acetate (PMA) were selected. Benfotiamine as well as α-tocopherol proved in the course of the experiments to be able to prevent angiotensin II-induced formation of oxidative DNA strand breaks and micronuclei. This could be due to a prior inhibition of the release of reactive oxygen species and is in contrast to results which were achieved using thiamine. Furthermore, experiments in which cells were pre-incubated with benfotiamine followed by incubation with NQO showed that benfotiamine was not able to prevent the induction of oxidative stress. The hypothesis that benfotiamine has, like α-tocopherol, direct antioxidative capacity was fortified by measurements in cell free systems. In brief, a new working mechanism for benfotiamine in addition to the ones already known could be provided. In the second part of the study, angiotensin II was shown to be dose-dependently genotoxic. This effect is mediated via the angiotensin II type 1 receptor (AT1R) which. Further experiments were extended from in vitro settings to the isolated perfused kidney. Here it could be shown that angiotensin II caused vasoconstriction and DNA strand breaks. Co-perfusion of kidneys with angiotensin II and candesartan prevented vasoconstriction and formation of strand breaks. DNA strand break formation due to mechanical stress or hypoxia could be ruled out after additional experiments with the thromboxane mimetic U 46619. Detailed investigation of the DNA damage in vitro revealed that angiotensin II induces single strand breaks, double strand breaks and 8-hydroxydeoxyguanosine (8-oxodG)-adducts as well as abasic sites. Investigations of the effects of aldosterone-treatment in kidney cells showed an increase of oxidative stress, DNA strand breaks and micronuclei which could be prevented by the steroidal mineralocorticoid receptor antagonist eplerenone. Additional experiments with the non-steroidal mineralocorticoid receptor antagonist (S)-BR-4628 revealed that this substance was also able to prevent oxidative stress and genomic damage and proved to be more potent than eplerenone. In vivo, hyperaldosteronism was imitated in rats by aid of the deoxycorticosteroneacetate (DOCA) salt model. After this treatment, levels of DNA strand breaks and chromosomal aberrations in the kidney could be observed. Furthermore, an increase in the release of ROS could be measured. Treatment of these animals with spironolactone , BR-4628 and enalaprile revealed that all antagonists were effective BR-4628 was the most potent drug. Finally, rosuvastatin was investigated. In HL-60 cells phorbol 12-myristate 13-acetate caused oxidative stress. Rosuvastatin was able to prevent the release of ROS and subsequent oxidative DNA damage when co-incubated with PMA. Furthermore, not only an inhibition of PMA-induced oxidative stress but also inhibition of the unspecific release of ROS induced by hydrogen peroxide was observable. Addition of farnesyl pyrophosphate (FPP), geranylgeranyl pyrophosphate (GGPP), and mevalonate, intermediates of the cholesterol pathway, caused only a marginal increase of oxidative stress in cells treated simultaneously with PMA and rosuvastatin, thus indicating the effect of rosuvastatin to be HMG-CoA-reductase-independent. Investigation of the gene expression of subunits of NAD(P)H oxidase revealed a down-regulation of p67phox following rosuvastatin-treatment. Furthermore, it could be shown that rosuvastatin treatment alone or in combination with PMA increased total glutathione levels probably due to an induction of the gene expression and enzyme activity of γ-glutamylcysteine synthetase (γ-GCS). / Im Zuge dieser Studie wurden sowohl endogene Substanzen als auch Modellsubstanzen eingesetzt, um die pathologischen Verhältnisse in Patienten, die an Bluthochdruck leiden, zu imitieren. Als endogene Substanzen wurden Angiotensin II und Aldosteron ausgewählt. Als Modellsubstanzen wurden 4-Nitrochinolin-1-oxid (NQO), Wasserstoffperoxid und Phorbol-12-myristat-13-gewählt. Der erste Teil dieser Arbeit beschäftigt sich mit zwei Vitaminen, nämlich Benfotiamin und α-Tocopherol. Sowohl Benfotiamin als auch α-Tocopherol zeigten im Laufe der Experimente, dass sie in der Lage sind, durch Angiotensin II verursachte DNA-Strangbrüche und chromosomale Aberrationen zu verhindern. Dies ist möglicherweise auf eine ebenfalls beobachtbare vorausgegangene Inhibition der Freisetzung reaktiver Sauerstoffspezies zurückzuführen. Zusammenfassend konnte ein neuer Wirkmechanismus für Benfotiamin vorgestellt werden. Im zweiten Teil dieser Studie konnte nachgewiesen werden, dass Angiotensin II eine dosisabhängige Gentoxizität verursacht. Dieser Effekt wird durch den Angiotensin II-Rezeptor Typ 1 vermittelt. Im weiteren Verlauf der Studie wurden die in vitro Experimente auf das Modell der isolierten perfundierten Mäuseniere ausgeweitet. Hier konnte gezeigt werden, dass Angiotensin II Vasokonstriktion und DNA-Strangbrüche verursacht. Co-Perfusion der Nieren mit Angiotensin II und Candesartan verhinderte hingegen die Vasokonstriktion und die Bildung von DNA-Strangbrüchen. Die Verursachung von Strangbrüchen durch mechanischen Stress oder Hypoxie konnte ausgeschlossen werden. Die Untersuchung der ex vivo beobachteten DNA-Schäden in vitro ließ erkennen, dass Angiotensin II Einzelstrangbrüche, Doppelstrangbrüche, die Bildung des DNA-Addukts 8-OxodG und abasische Stellen induziert. Ein Reparatur-Comet Assay, parallel durchgeführt mit der Messung des phosphorylierten Histons 2AX (γ-H2AX) über 24 h, zeigte eine vollständige Reparatur der Einzelstrangbrüche, wohingegen die Zahl der Doppelstrangbrüche in diesem Zeitraum sogar zunahm. Untersuchungen der Effekte, die eine Aldosteron-Behandlung auf Nierenzellen hat, zeigten einen Anstieg des oxidativen Stress, der DNA Strangbrüche und der Mikrokerne. Diese Effekte konnten durch Eplerenon verhindert werden. Weitere Experimente mit dem nicht-steroidalen Mineralocorticoid Rezeptor-Antagonisten (S)-BR-4628 zeigten, dass auch diese Substanz oxidativen Stress und DNA Schäden verhindern konnte, im Gegensatz hierzu hatte das (R)-Isomer, das keine Aktivität am Mineralocorticoid Rezeptor zeigt, keine präventiven Effekte. In vivo wurde der Hyperaldosteronismus mit Hilfe des Deoxycorticosteronacetat- (DOCA) Salzmodells nachgeahmt. Unter dieser Behandlung konnten Level an DNA-Strangbrüchen und chromosomalen Aberrationen beobachtet werden. Des Weiteren konnten in den DOCA-Tieren erhöhte Level an oxidativem Stress gemessen werden. Wurden die Versuchstiere zusätzlich zur DOCA-Behandlung mit Spironolacton, BR-4628 und dem Enalapril behandelt, konnte gezeigt werden, dass BR-4628 potenter war als Spironolacton Enalapril. Zuletzt wurde mit Rosuvastatin eine Substanz untersucht, die die antioxidative Abwehr der Zellen aktivieren kann. In der humanen Leukämie-Zelllinie HL-60 verursachte Phorbol-12-myristat-13-acetat (PMA) oxidativen Stress. Rosuvastatin war in der Lage, die Freisetzung von ROS und daraus resultierende DNA-Strangbrüche bei Co-Inkubation mit PMA zu verhindern. Außerdem konnte gezeigt werden, dass Rosuvastatin nicht nur PMA-induzierten oxidativen Stress, sondern auch die unspezifische Wasserstoffperoxid-induzierte Freisetzung von ROS verhinderte. Die Untersuchung der Genexpression von Untereinheiten der NAD(P)H Oxidase ergab, dass p67phox nach Rosuvastatin-Behandlung herabreguliert wurde. Behandlung mit Rosuvastatin allein oder zusammen mit PMA konnte außerdem die Glutathion-Spiegel erhöhen. Dies ist vermutlich auf die Induktion der Genexpression und der Enzymaktivität der γ-Glutamylcystein-Synthetase (γ-GCS), des Schrittmacherenzyms des Glutathionsystems, zurückzuführen.

O objetivo deste estudo foi avaliar se a infusão de angiotensina II (ANG II) modulava a expressão do receptor B1 (RB1) de cininas em aorta (AO),arteríolas mesentéricas (AM) de ratos Wistar e também verificar a influência do RB1 na pressão arterial e reatividade desses vasos sanguíneos através do agonista de RB1, DABK. Os ratos receberam por 28 dias infusão de ANG II ou de ANG II e antagonista de RB1. O DABK induziu relaxamento dependente de endotélio e NO em anéis de AO de ratos ANG II. A infusão de ANG II causou hipertensão arterial, aumento da expressão de RNAm de RB1 em AO e AM, da expressão protéica de RB1 em AO e disfunção endotelial caracterizada por diminuída resposta á acetilcolina (ACH).O antagonista de B1R não interferiu no desenvolvimento de hipertensão e na disfunção endotelial causada, mas aumentou a sensibilidade da AO à ACH e a expressão de NO Sintase nos ratos ANG II. Esses resultados nos permitem sugerir que a ANG II e cininas podem atuar sinergicamente no desenvolvimento das alterações vasculares observadas nesse modelo de hipertensão arterial. / The aim of the present study was to evaluate whether the angiotensin II (ANG II) infusion modulates the kinin B1 receptor (B1R) mRNA, protein expression in aorta (AO) and mesenteric arterioles (MA) in Wistar rats. It was also verified the role of RB1 in the control of blood pressure and vascular reactivity using DABK a B1R agonist Rats were infused either with ANG II (400ng/Kg/min) or ANG II plus RB1antagonist(350ng/Kg/min) during 28 days.DABK induced endothelium-NO dependent relaxation in AO of ANG II rats. ANG II infusion caused hypertension, increased RB1 mRNA expression in AO and MA, protein expression in AO and caused endothelial dysfunction, characterized as a decreased maximal response to acetylcholine (ACH). The B1R antagonist did not interfere in the development of hypertension and endothelium dysfunction caused by ANG II, however, increased the sensitivity to ACH and NO synthase expression in AO of ANG II rats. Altogether, we may suggest that ANG II and kinins can act synergistically in the development of vascular changes in this model of hypertension.

O objetivo deste estudo foi avaliar se a infusão de angiotensina II (ANG II) modulava a expressão do receptor B1 (RB1) de cininas em aorta (AO),arteríolas mesentéricas (AM) de ratos Wistar e também verificar a influência do RB1 na pressão arterial e reatividade desses vasos sanguíneos através do agonista de RB1, DABK. Os ratos receberam por 28 dias infusão de ANG II ou de ANG II e antagonista de RB1. O DABK induziu relaxamento dependente de endotélio e NO em anéis de AO de ratos ANG II. A infusão de ANG II causou hipertensão arterial, aumento da expressão de RNAm de RB1 em AO e AM, da expressão protéica de RB1 em AO e disfunção endotelial caracterizada por diminuída resposta á acetilcolina (ACH).O antagonista de B1R não interferiu no desenvolvimento de hipertensão e na disfunção endotelial causada, mas aumentou a sensibilidade da AO à ACH e a expressão de NO Sintase nos ratos ANG II. Esses resultados nos permitem sugerir que a ANG II e cininas podem atuar sinergicamente no desenvolvimento das alterações vasculares observadas nesse modelo de hipertensão arterial. / The aim of the present study was to evaluate whether the angiotensin II (ANG II) infusion modulates the kinin B1 receptor (B1R) mRNA, protein expression in aorta (AO) and mesenteric arterioles (MA) in Wistar rats. It was also verified the role of RB1 in the control of blood pressure and vascular reactivity using DABK a B1R agonist Rats were infused either with ANG II (400ng/Kg/min) or ANG II plus RB1antagonist(350ng/Kg/min) during 28 days.DABK induced endothelium-NO dependent relaxation in AO of ANG II rats. ANG II infusion caused hypertension, increased RB1 mRNA expression in AO and MA, protein expression in AO and caused endothelial dysfunction, characterized as a decreased maximal response to acetylcholine (ACH). The B1R antagonist did not interfere in the development of hypertension and endothelium dysfunction caused by ANG II, however, increased the sensitivity to ACH and NO synthase expression in AO of ANG II rats. Altogether, we may suggest that ANG II and kinins can act synergistically in the development of vascular changes in this model of hypertension.

Previous studies have used new angiotensin II (AII) receptor subtype selective compounds to localize AII receptor subtypes within discrete rat brain nuclei. The purpose of this autoradiographic study was to extend these preliminary findings and provide a comprehensive analysis of AII binding sites in 22 rat brain nuclei and the anterior pituitary, to include estimates of the binding affinity for 125I sar1 ile8 AII (125I SIAII) at each nucleus, and determine the fractional distribution of each subtype at each nucleus. Estimates of K(D), in separate experiments revealed that AT1 nuclei had a consistently higher affinity for 125I SIAII than AT2 nuclei (0.66 vs. 2.55 nM). Displacement of subsaturating concentrations of 125I SIAII by 10-8-10-4 M DuP753 (selective for the AT1 subtype) or PD123177 (selective for the AT2 subtype) indicated that approximately half of the brain regions surveyed contained predominantly AT1 sites and half contained predominantly AT2 sites. Binding was partially displaced by both compounds in several regions and two site analyses were performed to estimate the distribution of subtypes within each nucleus. The data were then corrected for differential occupancy by 125I SIAII. Brain nuclei associated with cardiovascular or dipsogenic actions of AII, e.g., subfornical organ, organum vasculosum of the lamina terminalis, median preoptic nucleus, nucleus of the solitary tract and area postrema, contained pure, or almost pure, populations of AT1 receptors. The functions of AII in brain regions containing predominantly AT2 binding sites, e.g., thalamus, colliculi, inferior olive and locus ceruleus, remain undefined. Thus, AII binding sites in the rat brain have been differentiated into two subtypes with similar characteristics to those reported in peripheral tissues. However, the unexpected finding that they can be differentiated on the basis of their affinity for 125I SIAII raises questions concerning their coidentity with peripheral receptor subtypes.

Les maladies cardio-vasculaires sont responsables de la vaste majorité des décès dans les pays industrialisés. La plupart de ces maladies sont dues à l'athérosclérose, processus manifesté par le développement de lésions (plaques d'athéromes) dans les parois vasculaires. La présence de ces plaques conduit à la réduction de la lumière du vaisseau et, par conséquent, à des complications graves, tel que l'infarctus du myocarde. Les patients ont pour issue la méthode d'angioplastie qui consiste à écraser la plaque athéromateuse à l'aide d'un ballonnet pour accroître la lumière du vaisseau obstrué. Toutefois, cette intervention entraîne une abrasion de l'endothélium et un étirement important des cellules musculaires lisses (CML) situées dans la profondeur de la paroi. Chez environ un tiers à la moitié des patients, la multiplication des CMLs conduit à une nouvelle réduction de la lumière artérielle. C'est la resténose. Les travaux de recherche ont permis le déploiement de plusieurs thérapies pharmacologiques et mécaniques mais les résultats tant anticipés suite aux études animales ne sont pas reproductibles chez l'humain pour la vaste majorité des tactiques. Notre équipe s'est intéressée au Système Rénine-Angiotensine (SRA) car son implication dans la resténose est non-négligeable. De plus, le succès des inhibiteurs de l'enzyme de conversion de l'angiotensine (iECA) chez l'animal a confirmé son rôle. Cependant, les essais cliniques ne sont guère convaincants et c'est ce qui a incité plusieurs à s'intéresser aux récepteurs de !'angiotensine II (Ang Il). Nos études antérieures avec le modèle de la carotide de rat ont révélé que les antagonistes non-peptidiques de l' Ang II sélectifs pour AT[indice inférieur 1] diminuaient partiellement la prolifération néointimale. Parallèlement, nous avions traité nos animaux avec un antagoniste peptidique non-sélectif pour réaliser que ce dernier en inhibait la presque totalité. Notre hypothèse de travail est que les antagonistes nonpeptidiques et les iECAs ont une efficacité limitée sur la réduction myointimale. Nous avons effectué une courbe dose-réponse avec un antagoniste non-peptidique sélectif pour AT[indice inférieur 1] et une seconde courbe avec un antagoniste non-peptidique mais sélectif pour les deux sous-types de récepteurs (AT[indice inférieur 1] et AT[indice inférieur 2]. De plus, nous avons traité nos animaux avec un iECA seul et combiné avec un antagoniste non-peptidique. Le bilan confirme l'efficacité limitée des antagonistes non-peptidiques de I' Ang II et établit que la coapplication de drogues ne suffit pas pour réduire la prolifération néointimale avec la même efficacité qu'observée avec l'antagoniste peptidique. Dans un deuxième temps, nous avons cherché à développer un nouveau modèle animal de la resténose afin de palier aux critiques dont font l'objet les modèles actuels et aussi permettre la validation de nos données antérieures. Nous suggérons que le furet pourrait devenir une bonne alternative aux modèles existants.

The mas proto-oncogene encodes a seven transmembrane protein (MAS) which is suggested to function as a receptor for angiotensin. It (MAS) was initially identified in NIH-3T3 cells that were transformed with DNA isolated from a human epidermoid carcinoma. These cells formed foci in culture and tumors when injected into nude mice. On the other hand, untransformed cells did not. Further analysis of these cells showed that transformed cells bind increased levels of angiotensin when compared to untransformed cells. These studies also demonstrated that the Mas protein was structurally similar to the angiotensin receptor transmembrane proteins, AT1 and AT2 . This investigation was undertaken to examine the ability of the Mas protein to function as an receptor for angiotensin and promote cell proliferation. To this end, quantitation of mas genes by Polymerase Chain Reaction (PCR) and serial dilutions, and Southern blot analysis support an increased in mas genes in transformed cells. Northern blot analysis demonstrated an increased expression of the mas gene in transformed cells. No changes in the level of the AT2 angiotensin receptor gene expression was observed in the transformed and untransformed cell lines. Expression of the AT1 angiotensin receptor gene was not observed in these cell lines. Anti-peptide antibodies were generated against the 1st and 2nd extracellular regions of the Mas protein. Flow cytometric analysis using these antibodies indicated an increased presence of the Mas protein on the surf ace of transformed cells recognized by anti-peptide antibodies. Western blot analysis showed two cross-reacting proteins of approximately ll0kd and 66kd in transformed cells; whereas, only a 66kd protein was found in untransformed cells. Transformed cells exposed to mas antisense oligos greatly reduced the synthesis of Mas, decreased cell proliferation and the binding of angiotensin. Binding studies using [3H]-DUP- 753 (a non-peptidyl ligand which recognizes Ang subtype AT1 receptors) showed little binding to transformed cells. Similar studies using PD-123319 (a non-peptidyl ligand that recognizes AT2 subtype receptors) indicated that approximately 60% of [125I]-Ang II was displaced using PD-123319. Further binding analysis of transformed cells suggests that [Sarl]-Ang II (an Ang II antagonist) could not completely displace [ 125I]-Ang II. Taken together, these data suggest that Mas protein is an Ang receptor which functions in the regulation of cell proliferation. Mas appears to be a member of a subtype different from AT1 or AT2.

Class of 2010 Abstract / OBJECTIVES: To comprehensively review medical literature and report angiotension converting enzyme inhibitors (ACE-­‐I) adverse drug reactions including, incidences, mechanism of action, predisposing conditions, and report prevention and treatments. METHODS: This was a descriptive retrospective study of data related to ACE-­‐I adverse drug reactions other than ACE-­‐I induced cough. It was to review the ADR that accompany with the use of ACE-­‐I. Literature obtained through search engines MEDLINE and OVID SP available through the Arizona Health and Science Library at the University of Arizona. RESULTS: This comprehensive literature review looked at angioneurotic edema, orthostatic hypotension, hyperkalemia, and increased risk of bleeding and anaphylaxis with tPA and to a minor extent Elevated serum creatinine, and Teratogenicity. Angioneurotic edema (angioedema) reports initially estimated an incidence of 0.1 to 0.7%. A comprehensive review suggested the incidence was even lower at 0.1 to 0.2%, but the OCTAVE trial that specifically looked at angioedema as an endpoint estimated an incidence of ~0.7% although the study only had a 24-­‐week follow up. Most patients that discontinued treatment due to angioedema experienced symptom relief within 72 hours. The incidence of orthostatic hypotension from a study that followed patients on lisinopril was only 0.25%;moreover, a meta-­‐analysis by Agusti et al included 51 RCT that reported a relative risk of developing OH on an ACE-­‐I alone was 1.95. Hyperkalemia incidence reporeted varied from 1.1% to 10%; the more recent literature suggests a value near the lower end of this range. Elevated serum creatinine appears to occur early in ACE-­‐I treatment with discontinuation resolving in resolution. ACE-­‐I have been shown to be teratogenic during any trimester and should generally be avoided in pregnancy. There appears to be an increased risk of bleeding and anaphylactoid typer reactions when alteplase and ACE-­‐I are used simultaneously. Muravyov et al reported the viscosity of whole blood and plasma to be decreased after only three weeks of ACE-­‐I administration. CONCLUSIONS: With the continued increasing use of ACE-­‐Is and the drug class' ability to achieve therapeutic outcomes in a wide array of patient populations, it is important to better understand the processes and mechanisms behind the ADRs associated with ACE-­‐I therapy. A basic understanding of incidence rates and physiologic mechanisms will allow clinicians to properly assess the probability of causation and better treat patients who have experienced an ACE-­‐I induced ADR. However, an in-­‐depth level of understanding can help guide clinicians in making decisions that will hopefully decrease the amount of ADRs their patients experience or prevent their patients from developing ACE-­‐I related ADR altogether. It is important to note that, in most of the aforementioned ADR situations, treatment consists of ACE-­‐I discontinuation and avoidance of future exposures.

Women with preeclampsia have enhanced vascular reactivity to Angiotensin II (Ang II) and extensive vascular infiltration of neutrophils. The primary mechanism to enhance vessel reactivity is RhoA kinase that phosphorylates MYPT1 to inhibit myosin light chain (MLC) phosphatase. Therefore, MLCs remain phosphorylated and increase sensitivity to calcium. Neutrophils release reactive oxygen species (ROS), which can activate this pathway, so we hypothesized that neutrophils would enhance vessel reactivity to Ang II. Omental vessels from normal pregnant women were used to study vascular reactivity. Ang II dose response (0.001-10µM) was significantly enhanced with perfusion of neutrophils (<2000/mm3, activated with IL-8) or ROS. Addition of superoxide dismutase (SOD)/Catalase to quench ROS or 3µM Y-27632, a specific RhoA kinase inhibitor, blocked enhancement. Vascular smooth muscle expression of pMYPT1 and pMLC in cell culture was significantly increased by neutrophils or ROS. The increase was prevented by Y-27632. RhoA kinase activity assay showed a 3-fold increase in RhoA kinase activity in omental vessels treated with ROS. Similarly, ROS also enhanced vessel reactivity to another vasoconstrictor, norepinephrine, via RhoA kinase. In preeclamptic women, increased neutrophil infiltration is associated with increased vascular expression and production of matrix metalloproteinase-1 (MMP-1). MMP-1 activates protease activated receptor-1 (PAR-1), which could cause endothelial endothelin-1 release, so we considered a novel hypothesis that MMP-1 might cause vasoconstriction and enhance vessel reactivity to Ang II via PAR-1. Omental vessels perfused with activated MMP-1 (0.025-25ng/ml) showed dose-dependent vasoconstriction. Perfusion of activated MMP-1 (2.5ng/ml) significantly enhanced dose response to angiotensin II. MMP-1 mediated vasoconstriction and enhanced vessel reactivity to Ang II was abolished by co-perfusion of 10µM SCH-79797, a specific PAR-1 blocker, and by 5µM BQ-123, a specific endothelin-1 type A receptor blocker. These data are the first to show that activated neutrophils enhance vascular reactivity to Ang II via ROS and the RhoA kinase pathway. They are also the first to show that MMP-1 induces vasoconstriction and enhances vessel reactivity to Ang II. Thus, vascular neutrophil infiltration leading to ROS and MMP-1 generation could be an important mechanism for hypertension in preeclampsia.

Reactive oxygen species (ROS) are continuously generated in cells and are involved in physiological processes including signal transduction but also their damaging effects on biological molecules have been well described. A number of reports in the literature implicate excessive oxidative stress and/or inadequate antioxidant defense in the pathogenesis of cancer, atherosclerosis, chronic and age related disorders. Several studies have indicated that activation of the renin-angiotensin-aldosterone-system can lead to the formation of ROS. Epidemiological studies have revealed higher renal cell cancer incidences and also higher cancer mortalities in hypertensive individuals. Recently, our group has shown that perfusion of the isolated mouse kidney with Ang II or treatment of several cell lines with Ang II leads to formation of DNA damage and oxidative base modifications. Here, we tried to scrutinize the pathway involved in genotoxicity of Ang II. We confirmed the genotoxicity of Ang II in two kidney cell lines of human origin. Ang II treatment led to the production of superoxide anions which we could hinder when we used the membrane permeable superoxide dismutase (SOD) mimetic TEMPOL. One of the enzymes which is activated in the cells after Ang II treatment and is able to produce ROS is NADPH oxidase. We demonstrated the activation of NADPH oxidase in response to Ang II by upregulation of its p47 subunit using RT-PCR. Also, pPhosphorylation of p47 subunit of NADPH oxidase after Ang II treatment was enhanced. Using two inhibitors we showed that NADPH oxidase inhibition completely prevents DNA damage by Ang II treatment. To differentiate between Nox2 and Nox4 isoforms of NADPH oxidase subunits in the genotoxicity of Ang II, we performed siRNA inhibition and found a role only for Nox4, while Nox2 was not involved. Next, we investigated PKC as a potential activator of NADPH oxidase. We showed that PKC becomes phosphorylated after Ang II treatment and also that inhibition of PKC hinders Ang II from damaging the cells. Our results from using several inhibitors of different parts of the pathway revealed that PKC activation in this pathway is dependent on the action of PLC on membrane phospholipids and production of IP3. IP3 binds to its receptor at endoplasmic reticulum (ER), opening a channel which allows calcium efflux into the cytoplasm. In this manner, both ER calcium stores and extracellular calcium cooperate so that Ang II can exert its genotoxic effect. PLC is activated by AT1R stimulation. We could also show that the genotoxicity of Ang II is mediated via AT1R signaling using the AT1R antagonist candesartan. In conclusion, here we have shown that Ang II is able to damage genomic damage in cell lines of kidney origin. The observed damage is associated with production of ROS. A decrease in Ang II-induced DNA damage was observed after inhibition of G-proteins, PLC, PKC and NADPH oxidase and interfering with intra- as well as extracellular calcium signaling. This leads to the following preliminary model of signaling in Ang II-induced DNA damage: binding of Ang II to the AT1 receptor activates PLC via stimulation of G-proteins, resulting in the activation of PKC in a calcium dependent manner which in turn, activates NADPH oxidase. NADPH oxidase with involvement of its Nox4 subunit then produces reactive oxygen species which cause DNA damage. Dopamine content and metabolism in the peripheral lymphocytes of PD patients are influenced by L-Dopa administration. The PD patients receiving a high dose of L-Dopa show a significantly higher content of dopamine in their lymphocytes compared to PD patients who received a low dose of L-Dopa or the healthy control. Central to many of the processes involved in oxidative stress and oxidative damage in PD are the actions of monoamine oxidase (MAO), the enzyme which is responsible for the enzymatic oxidation of dopamine which leadsing to production of H2O2 as a by-product. We investigated whether dopamine oxidation can cause genotoxicity in lymphocytes of PD patents who were under high dose L-Dopa therapy and afterward questioned the occurrence of DNA damage after dopamine treatment in vitro and tried to reveal the mechanism by which dopamine exerts its genotoxic effect. The frequency of micronuclei in peripheral blood lymphocytes of the PD patients was not elevated compared to healthy age-matched individuals, although the formation of micronuclei revealed a positive correlation with the daily dose of L-Dopa administration in patients who received L-Dopa therapy together with dopamine receptor agonists. In vitro, we describe an induction of genomic damage detected as micronucleus formation by low micromolar concentrations in cell lines with of different tissue origins. The genotoxic effect of dopamine was reduced by addition of the antioxidants TEMPOL and dimethylthiourea which proved the involvement of ROS production in dopamine-induced DNA damage. To determine whether oxidation of dopamine by MAO is relevant in its genotoxicity, we inhibited MAO with two inhibitors, trans-2-phenylcyclopropylamine hydrochloride (PCPA) and Ro 16-6491 which both reduced the formation of micronuclei in PC-12 cells. We also studied the role of the dopamine transporter (DAT) and dopamine type 2 receptor (D2R) signaling in the genotoxicity of dopamine. Inhibitors of the DAT, GBR-12909 and nomifensine, hindered dopamine-induced genotoxicity. These results were confirmed by treatment of MDCK and MDCK-DAT cells, the latter containing the human DAT gene, with dopamine. Only MDCK-DAT cells showed elevated chromosomal damage and dopamine uptake. Although stimulation of D2R with quinpirole in the absence of dopamine did not induce genotoxicity in PC-12 cells, interference with D2R signaling using D2R antagonist and inhibition of G-proteins, phosphoinositide 3 kinase and extracellular signal-regulated kinases reduced dopamine-induced genotoxicity and affected the ability of DAT to take up dopamine. Furthermore, the D2R antagonist sulpiride inhibited the dopamine-induced migration of DAT from cytosol to cell membrane. Overall, the neurotransmitter dopamine causes DNA damage and oxidative stress in vitro. There are also indications that high dose L-Dopa therapy might lead to oxidative stress. Dopamine exerts its genotoxicity in vitro upon transport into the cells and oxidization oxidation by MAO. Transport of dopamine by DAT has the central role in this process. D2R signaling is involved in the genotoxicity of dopamine by affecting activation and cell surface expression of DAT and hence modulating dopamine uptake. We provided evidences for receptor-mediated genotoxicity of two compounds with different mechanism of actions. The involvement of these receptors in many human complications urges more investigations to reveal whether abnormalities in the endogenous compounds-mediated signaling can play a role in the initiation of new conditions like carcinogenesis. / Reaktive Sauerstoffspezies (ROS) werden kontinuierlich in Zellen generiert und sind an physiologischen Prozessen wie der Signaltransduktion beteiligt. Aber auch ihre schädigenden Auswirkungen auf biologische Moleküle sind seit langem bekannt. Eine Reihe von Literaturberichten sieht einen Zusammenhang zwischen übermäßigem oxidativen Stress oder einer unzureichenden antioxidativen Verteidigung und Krebs, Atherosklerose und chronischen bzw. altersbedingten Erkrankungen. Mehrere Studien haben belegt, dass die Aktivierung des Renin-Angiotensin-Aldosteron-Systems zur Bildung von ROS führen kann. Epidemiologische Studien haben gezeigt, dass Nierenkarzinom-Inzidenzen und -Mortalitäten bei Hypertonikern erhöht sind. Vor kurzem konnte unsere Gruppe zeigen, dass die Perfusion von isolierten Maäusen-Nieren und dieoder Behandlung mehrerer Zelllinien mit Angiotensin II (Ang II) zur Bildung von DNA-Schäden und oxidativen Basenmodifikationen führt. Ziel der vorliegenden Arbeit war es, die Signalwege der Genotoxizität von Ang II zu bestimmen. Wir bestätigten dDie Genotoxiziät von Ang II in zwei Nieren-Zelllinien humaner Herkunft konnte bestätigt werden. Wir zeigten, dass Ang II-Behandlung zur Produktion von Superoxid-Anionen führt, die durch das membrangängige Superoxid-Dismutase-Mimetikum TEMPOL verhindert werden kann. Eines der Enzyme, das in den Zellen nach Ang II-Behandlung aktiviert wird und ROS produzieren kann, ist die NADPH-Oxidase. Die mittels RT-PCR gemessene Hochregulierung von p47 beweist die Aktivierung der NADPH-Oxidase nach Ang II-Behandlung. Auch die Phosphorylierung von p47 nach Ang II-Behandlung wurde gesteigert. Mittels zweier Inhibitoren zeigten wir, dass NADPH-Oxidase-Hemmung DNA-Schäden durch Ang II-Behandlung vollständig verhindert. Wir versuchten, die Rolle der Nox2- und Nox4-Isoformen der NADPH-Oxidase-Untereinheiten bei der Genotoxizität von Ang II zu differenzieren. Hemmung mittels siRNA bestätigte nur eine Beteiligung der Nox4. Anschließend überprüften wir die Rolle der PKC als potentiellem Aktivator der NADPH-Oxidase. Wir zeigten, dass die PKC nach Ang II-Behandlung PKC phosphoryliert wird und durch die Hemmung der PKC Ang II-induzierten Schäden verhindert werdenird. Die Verwendung mehrerer Inhibitoren der verschiedenen Teile des Signalweges zeigte, dass die PKC-Aktivierung von der Reaktion der PLC mit Membranphospholipiden und der Produktion von IP3 und DAG abhängig ist. IP3 bindet an seinen Rezeptor am Endoplasmatischen Retikulum (ER)., dDie in der Folge auftretende Öffnung eines Kanals ermöglicht einen Calcium-Ausstrom in das Cytoplasma. Auf diese Weise sind sowohl ER-Calcium als auch extrazelluläres Calcium an der Ang II-induzierten genotoxische Wirkung beteiligt. PLC wird durch AT1R-Stimulation aktiviert. Wir konnten mit Hilfe des AT1R-Antagonisten Candesartan auch zeigen, dass die Genotoxizität von Ang II über AT1R-Signaltransduktion vermittelt wird. Zusammenfassend haben wir gezeigt, dass Ang II genomische Schäden in humanen Nieren-Zelllinien verursacht. Die Schäden sind mit der Produktion von ROS verbunden. Eine Reduktion der Ang II-induzierten DNA-Schäden wurde nach Hemmung vonder G-Proteinen, der PLC, PKC und NADPH-Oxidase und Beeinflussung intra- sowie extrazellulärer Calium-Signalgebung gezeigt. Dies führt zu folgendem vorläufigen Modell der Signaltransduktion der von Ang II-induzierten DNA-Schäden: Die Bindung von Ang II an den AT1-Rezeptor aktiviert die PLC durch Stimulationerung der G-Proteine und die PKC in Calcium-abhängiger Weise, dies wiederum aktiviert die NADPH-Oxidase. Die NADPH Oxidase unter Beteiligung ihrerseiner Nox4-Untereinheit erzeugt dann reaktive Sauerstoffspezies, die DNA-Schäden verursachen. Dopamingehalt und -stoffwechsel in peripheren Lymphozyten von Parkinson-Patienten werden durch L-Dopa-Gabe beeinflusst. Die Patienten, die eine hohe Dosis L-Dopa erhalten, zeigen einen signifikant höheren Gehalt an Dopamin in den Lymphozyten im Vergleich zu Patienten, die eine niedrige Dosis L-Dopa erhalten oder der gesunden Kontrollgruppe. Im Mittelpunkt vieler Prozesse bei der Entstehung von oxidativem Stress und oxidativer Schäden bei Parkinson-Patienten steht die Monoaminoxidase (MAO), die für die enzymatische Oxidation von Dopamin und in der Folge für die Entstehung von H2O2 verantwortlich ist. Wir untersuchten, ob die Oxidation von Dopamin genotoxische Wirkung in Lymphozyten von Parkinson-Patienten mit hochdosierter L-Dopa-Therapie induzieren kann. Danach überprüftenfragten wir, ob die Behandlung mit Dopamin in vitro DNA-Schäden induzieren kann und versuchten aufzuzeigen, durch welchen Mechanismus Dopamin seine genotoxische Wirkung entfaltet. Die Häufigkeit von Mikrokernen in peripheren Lymphozyten der Parkinson-Patienten war nicht erhöht im Vergleich zur gesunden Kontrollgruppe, allerdings zeigte die Mikrokernfrequenz eine positive Korrelation mit der täglichen L-Dopa-Dosis bei Patienten, die eine L-Dopa-Therapie zusammen mit einem Dopamin-Rezeptor-Agonisten erhielten. In vitro beobachteten wir bei niedrigen mikromolaren Konzentrationen eine Induktion des genomischen Schadens in Zelllinien, die aus verschiedenen Geweben stammten. Die genotoxische Wirkung von Dopamin wurde durch Zugabe der Antioxidantien TEMPOL und DMTU reduziert, wodurch die Beteiligung von ROS gezeigt werden konnte. Um festzustellen, ob die Oxidation von Dopamin durch MAO für die Genotoxizität relevant ist, hemmten wir MAO mit zwei Inhibitoren, trans-2-Phenylcyclopropylamin-Hydrochlorid (PCPA) und Ro 16-6491, die beide die Bildung von Mikrokernen in PC-12-Zellen reduzieren konnten. Wir untersuchten auch die Rolle des Dopamin-Transporters (DAT) und Dopamin-Typ-2-Rezeptor (D2R)-assoziierter Signalwege in der Genotoxizität von Dopamin. Die Inhibitoren des DAT, GBR-12909 und Nomifensin verhinderten die Dopamin-induzierte Genotoxizität. Diese Ergebnisse wurden durch Behandlung von MDCK- und MDCK-DAT- Zellen (die das humane DAT-Gen besitzen) mit Dopamin bestätigt. Nur MDCK-DAT-Zellen zeigten erhöhte chromosomale Schäden und Dopaminaufnahme. Obwohl die Stimulation mit dem D2R-Rezeptor-Agonisten Quinpirol in Abwesenheit von Dopamin keine Genotoxizität in PC-12-Zellen induzierte, reduzierten sowohl ein D2R-Antagonist, wie auch Inhibitoren des in der Signalkaskade involvierten G-Proteins, der Phosphoinositol-3-Kinase und der extrazellulären signalregulierten Kinasen die Aufnahme von Dopamin mittels DAT und die Dopamin-vermittelte Genotoxizität. Der D2R-Antagonist Sulpirid hemmte die Dopamin-induzierte Migration von DAT aus dem Cytosol zur Zellmembran. Insgesamt verursacht der Neurotransmitter Dopamin DNA-Schäden und oxidativen Stress in vitro. Es gibt Hinweise, dass eine hochdosierte L-Dopa-Therapie zu oxidativem Stress führt. In vitro führt Dopamin zu Genotoxizität durch den Transport in die Zellen und Oxidation durch MAO. Der Transport von Dopamin durch DAT spielt eine zentrale Rolle in diesem Prozess. Die D2R-Signalwege sind an der Genotoxizität von Dopamin durch Auswirkung auf die Aktivierung und Membranexpression von DAT und damit der Dopaminaufnahme beteiligt.

Ph.D., Faculty of Health Sciences, University of the Witwatersrand, 2011 / In groups of African ancestry, who have a high prevalence of “salt-sensitive, low-renin” hypertension, there is considerable uncertainty as to relevance of the renin-angiotensin-aldosterone system (RAAS) in the pathophysiology of primary hypertension. In the present thesis I explored the possibility that the RAAS, through interactions with environmental effects, contributes to blood pressure (BP) in this ethnic group. After excluding participants with aldosterone-to-renin ratios (ARR) above the threshold for primary aldosteronism, in 575 participants of African ancestry, I demonstrated that with adjustments for confounders, an interaction between ARR and urinary Na+/K+ (and index of salt intake obtained from 24-hour urine samples) was independently associated with BP (p<0.0001). This effect was accounted for by interactions between serum aldosterone concentrations and urinary Na+/K+ (p<0.0001), but not between plasma renin concentrations and urinary Na+/K+ (p=0.52). The interaction between ARR and urinary Na+/K+ translated into a marked difference in the relationship between urinary Na+/K+ and BP in participants above and below the median for ARR (p<0.0001 for a comparison of the relationships). Having demonstrated that circulating aldosterone concentrations may account for a substantial proportion of the relationship between salt intake and BP in this community sample, I subsequently assessed whether genetic factors contribute toward serum aldosterone concentrations. In 153 randomly selected nuclear families of African ancestry consisting of 448 participants without primary aldosteronism, with, but not without adjustments for plasma renin concentrations, independent correlations were noted for iii serum aldosterone concentrations between parents and children (p<0.05), with parent-child partial correlation coefficients being greater than those for father-mother relationships (p<0.05). Furthermore, after, but not before adjustments for plasma renin concentrations, serum aldosterone concentrations showed significant heritability (h2=0.25±0.12, p<0.02). No independent relationships between RAAS gene polymorphisms and serum aldosterone concentrations were observed. I also aimed to assess whether RAAS genes modify the relationship between cigarette smoking and BP in groups of African descent. However, as the impact of mild smoking on BP is uncertain, and in the community studied only 14.5% smoked and the majority of smokers were mild smokers (mean=7.4±4.6 cigarettes per day) in 689 randomly participants I initially assessed the relationship between smoking habits and out-of-office BP. In this regard, current smokers had higher unadjusted and multivariate adjusted 24-hour systolic/diastolic BP (SBP/DBP in mm Hg) (p<0.005-p<0.0005) than non-smokers, effects that were replicated in sex-specific groups, non-drinkers, and in the overweight and obese. Current smoking was second only to age and at least equivalent to body mass index in the quantitative impact on out-of-office BP and the risk of uncontrolled out-of-office BP was increased in smokers as compared to non-smokers. Thus, despite minimal effects on in-office BP, predominantly mild current smoking was independently associated with an appreciable proportion of out-of-office BP in a community of African ancestry. In 652 participants I subsequently assessed whether the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism accounts for the strong relationships between predominantly mild smoking and out-of-office BP. After iv appropriate adjustments, an interaction between ACE DD genotype and current cigarette smoking, or the number of cigarettes smoked per day was independently associated with 24-hour and day diastolic BP (DBP) (p<0.05-0.005). This effect translated into a relationship between smoking and out-of-office BP or the risk for uncontrolled out-of-office BP only in participants with the DD as compared to the ID + II genotypes. In conclusion therefore, I afford evidence to suggest that in groups of African ancestry, aldosterone, within ranges that cannot be accounted for by the presence of primary aldosteronism, modifies the relationship between salt intake and BP, and that genetic factors account for the variation in serum aldosterone concentrations in this group. Furthermore, I show that the ACE gene modifies the relationship between smoking and out-of-office BP and hence accounts for even predominantly mild smoking producing a marked and clinically important effect on out-of-office BP. The present thesis therefore provides further evidence in favour of an important pathophysiological role for the RAAS in contributing toward BP in groups of African ancestry.