Thesis (Ph. D.)--Ohio State University, 2009. / Title from first page of PDF file. Includes vita. Includes bibliographical references (p. 120-134).

Thesis (Ph.D.)--University of Florida, 2004. / Typescript. Title from title page of source document. Document formatted into pages; contains 136 pages. Includes Vita. Includes bibliographical references.

Thesis (M. Med. Sc.)--University of Hong Kong, 2006.

Abstract Heart responds to pathological hemodynamic stress by increasing cardiac myocyte size, reprogramming gene expression and enhancing contractile protein synthesis. Neurohumoral factors mediate hypertrophic adaptation either directly via specific receptors or indirectly by increasing blood pressure and cardiac load. The aim of this study was to evaluate the role of angiotensin II (Ang II) in the atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) gene expression during cardiac overload. Furthermore, the mechanisms of action of Ang II in regulating cardiac gene expression were studied. Hemodynamic stress was produced by Ang II or nitric oxide (NO) synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME) administration in conscious rats. Despite hypertension and increased left ventricular ANP and BNP mRNA levels, L-NAME administration for 8 weeks did not induce left ventricular hypertrophy. Ang II type 1 receptor (AT1) antagonism decreased significantly L-NAME-induced hypertension and ventricular ANP gene expression. Ang II-induced cardiac overload produced significant increase in ventricular ANP and BNP mRNA levels at 12 and 72 h, respectively. To study whether the factors synthesized by adrenals modulate the response of Ang II, the effects of adrenalectomy were studied. In Ang II-treated rats, adrenalectomy either abolished or blunted the early activation of ANP and BNP gene expression, respectively. Ang II infusion for 2 weeks increased cardiac mass and blood pressure measured by telemetry, and produced changes in diastolic function detected by echocardiography. By using direct plasmid DNA injections into the rat myocardium, BNP promoter activity was observed to increase at 2 h and remain up-regulated up to 2 weeks of Ang II infusion, except at 12 h. BNP mRNA levels increased at 2 h but decreased to basal levels after 72 h. Mutation of GATA elements of the BNP promoter and DNA binding assays revealed that GATA4 mediates the Ang II-responsiveness of the BNP gene. These results indicate that Ang II plays an important role in regulating natriuretic peptide gene expression during cardiac overload. ANP and BNP gene expression in the rat heart is modulated by the adrenal factors during Ang II-stimulated hemodynamic stress and the AT1 receptor antagonism in NO-deficient hypertension. Moreover, ventricular BNP gene expression in Ang II-induced hypertension in vivo is controlled by posttranscriptional mechanisms and GATA elements.

Abstract Cardiac hypertrophy is an adaptive response of the heart to a variety of mechanical, hemodynamic, neurohumoral, and pathologic stimuli. Prolonged pathophysiological load leads to development of left ventricular hypertrophy and ultimately to heart failure. The natriuretic peptides including the B-type natriuretic peptide (BNP) provide the physiological feedback mechanism to suppress the load signal. The aim of the present study was to evaluate the cis elements within the BNP promoter that mediate the cardiac load responses in vivo, and to study the involvement of paracrine factors, such as endothelin-1 (ET-1) and angiotensin II (Ang II) in activating these transcription factors. In this study, cardiac overload was produced by bilateral nephrectomy, and infusions of arginine8-vasopressin (AVP) or Ang II. In isolated perfused rat heart, the direct wall stretch was achieved by inflating the left ventricular balloon. To identify the cis elements within the BNP promoter that mediate hemodynamic overload response, the approach of DNA injection into the myocardium was used. Mutation or deletion of proximal BNP GATA sites abrogated the response to nephrectomy. AVP-induced acute pressure overload increased left ventricular BNP mRNA and peptide levels. In gel mobility shift assays, pressure overload produced rapid activation of transcription factor GATA4 DNA binding, which was completely inhibited by the ET-1 receptor antagonist bosentan. Both ET-1 and Ang II receptor antagonism inhibited the wall stretch-induced increases in left ventricular GATA4 and AP-1 binding activities in isolated perfused heart preparation. BNP promoter activity and BNP mRNA and peptide levels were regulated distinctly in chronic hemodynamic overload produced by Ang II. In conclusion, GATA4 appears to be necessary and sufficient to confer transcriptional activation of BNP gene during hemodynamic stress in vivo. ET-1 is a signaling molecule mediating the cardiac response to acute pressure overload in vivo. In isolated rat heart, Ang II and ET-1 are required for the stimulation of GATA4 and AP-1 binding activity in response to direct left ventricular wall stretch. Finally, posttranscriptional mechanisms play an important role in the regulation of BNP gene expression in pressure overload produced by Ang II in vivo.

In recent decades, the acceptance has steadily increased that oxidative stress plays an important role in the development of chronic diseases, malignant neoplasia and the acceleration of the aging process. As one of the most common chronic diseases, hypertension is often associated with a misregulated renin-angiotensin-aldosterone system that causes chronic oxidative stress. Hypertension is a risk factor for neurological diseases such as vascular dementia (VaD) and many neurological disorders, including VaD, have an ROS-associated or inflammatory component in their etiology. Our group has already demonstrated AT-II-induced genotoxicity in kidney and myocardial cells and tissues. The aim of this dissertation was to investigate a possible association between AT-II and neurodegeneration that is triggered by neuronal genotoxicity of AT-II. First, we showed in two neuronal cell lines that AT-II causes dose-dependent genome damage. Subsequent experiments could attribute this toxicity to NOX-produced superoxide generated after AT-II binding to the AT1R. In addition, AT-II-induced depletion of the most important intracellular antioxidant - glutathione - was demonstrated. In vivo, we were able to show that AT1aR knockout mice after AT-II treatment showed significantly more genome damage in the subfornic organ (SFO) than wild-type mice. The SFO is one of the few structures in the brain with an interrupted blood-brain barrier, which makes it accessible and particularly sensitive to circulating AT-II. In the recent literature, these genome damages were also observed in kidney and heart tissues and prove an additional genotoxicity of AT-II independent of AT1aR and consequently independent of blood pressure. In summary, this work shows that increased AT-II levels in neuronal cells cause genome damage due to NOX-produced superoxide. It is hoped that these results will one day help to decipher the complete development of VaD. / In den letzten Jahrzehnten ist die Akzeptanz stetig größer geworden, dass oxidativer Stress eine bedeutende Rolle bei der Entstehung von chronischen Erkrankungen, malignen Neoplasien sowie der Beschleunigung des Alterungsprozesses spielt. Als eine der häufigsten chronischen Erkrankungen ist Hypertonie oft mit einem fehlregulierten Renin-Angiotensin-Aldosteron-System assoziiert, welches chronisch oxidativen Stress verursacht. Bluthochdruck ist ein Risikofaktor für neurologische Erkrankungen wie der vaskulären Demenz (VaD) und viele neurologischen Störungen, einschließlich der VaD, haben eine ROS-assoziierte beziehungsweise inflammatorische Komponente in ihrer Entstehung. Unsere Arbeitsgruppe konnte bereits eine AT-II-induzierte Genotoxizität in Nieren- und Myokardzellen bzw. -Gewebe nachweisen. Ziel dieser Dissertation war es, einen möglichen Zusammenhang zwischen AT-II und Neurodegeneration zu untersuchen, welche durch eine neuronale Genotoxizität von AT-II ausgelöst wird. Zunächst zeigten wir in zwei neuronalen Zelllinien, dass AT-II eine Dosis-abhängige Genomschädigung verursacht. Nachfolgende Experimente konnten diese Toxizität auf NOX-produziertes Superoxid zurückführen, das nach Bindung von AT-II an den AT1R generiert wird. Zudem konnte ein AT-II-induzierter Verbrauch des wichtigsten intrazellulären Antioxidans – Glutathion - nachgewiesen werden. In vivo konnten wir zeigen, dass AT1aR-Knockout-Mäuse nach AT-II-Behandlung signifikant mehr Genomschäden im Subfornikalorgan (SFO) aufwiesen als Wildtypmäuse. Das SFO hat als eine der wenigen Strukturen im Gehirn eine unterbrochene Blut-Hirn-Schranke, was es für zirkulierendes AT-II zugänglich und besonders empfindlich macht. Diese Genomschäden wurden in der neueren Literatur auch in Nieren- und Herzgewebe beschrieben und belegen eine zusätzliche, AT1aR- und damit Blutdruck-unabhängige Genotoxizität von AT-II. Zusammenfassend zeigt diese Arbeit, dass erhöhte AT-II-Konzentrationen in Nervenzellen Genomschäden durch NOX-produziertes Superoxid verursachen. Die Hoffnung ist, dass diese Ergebnisse dabei helfen, eines Tages die vollständige Entstehung der VaD zu entschlüsseln.

Ausgangspunkt der Arbeit ist die klinische Beobachtung, dass Patienten mit arteriellem Hypertonus vermehrt Nierenerkrankungen entwickeln. Dabei zeigten sich in der Subgruppenanalyse vor allem erhöhte Inzidenzen der Niereninsuffizienz und der Nierenzellkarzinome. Als möglicher Pathomechanismus steht das Renin-Angiotensin-Aldosteron-System (RAAS-System) im Vordergrund. Dabei wird postuliert, dass erhöhte Angiotensin II-Spiegel zu einem Missverhältnis zwischen den Oxidations- und Reduktionspartnern in der Zelle führen, wodurch sich das oxidative Potential der Zelle ändert, und es vermehrt zur Bildung von Radikalen (ROS) kommt, die meist ungepaarte Elektronen in der Valenzschale oder instabile Verbindungen enthalten, wodurch sie besonders reaktionsfreudig mit Proteinen, Lipiden, Kohlenhydraten und auch der DNA interagieren. In der Folge kommt es zu DNA-Veränderungen in Form von Doppel- oder Einzelstrangbrüchen, DNA-Protein-Crosslinks, Basenmodifikationen und Basenverlusten, wodurch sich ein hohes mutagenes Potential ergibt. Dieser Ansatz zur Pathophysiologie bestätigte sich auch an den hier verwendeten porkinen Nierenzellmodell. Dabei zeigte sich nicht nur eine Veränderung der genomischen Stabilität nach Exposition gegenüber erhöhten Angiotensin II-Spiegeln, sondern auch eine Veränderung der DNA in Abhängigkeit von der Expositionsdauer der Zellen. Als nächster Schritt konnte die Modulation der Transkriptionsfaktoren Nrf 2 und NF-κB durch die Behandlung mit Angiotensin II und Sulforaphan nachgewiesen werden. Bei der Behandlung mit Sulforaphan ließ sich eine Nrf 2-Induktion nachweisen mit vermehrter Expression von antioxidativen und detoxifizierender Enzyme. Weiterhin zeigte sich im Rahmen der Behandlung erniedrigte NF-κB-Level. Bei der Modulation durch Angiotensin II stellte sich zunächst ein signifikant erniedrigtes Level an Nrf 2 in den Zellen dar, das im Verlauf von 24 Stunden anstieg und konsekutiv ließ sich eine maximale Proteinexpression zwischen 24 und 48 Stunden messen. Weiterhin wiesen die Zellen, die mit Angiotensin II behandelt wurden, erhöhte NF-κB Mengen/Zelle auf. Zudem zeigte sich der Einfluss erhöhter Glucosekonzentrationen auf eine progrediente genomischen Instabilität, die Veränderung der Transkriptionsfaktoren mit erhöhter Nrf 2-Induktion und mit Deregulation des Transkriptionsfaktors NF-κB wurde durch die Behandlung mit Sulforaphan nachgewiesen. Aufgrund dieser Rolle in der Tumorgenese sind mittlerweile einige Bestandteile des NF-κB- und des Nrf 2-Signalweges und auch Nrf 2-Aktivatoren wie Sulforaphan wichtige Zielstrukturen für die Entwicklung neuer Medikamente und Therapieoptionen. Besonders zeigt sich hierbei die Wichtigkeit bei Diabetes induzierten kardiovaskulären Folgeschäden mit frühzeitiger medikamentöser Behandlung. / The starting point of this work is the clinical observation that patients with arterial hypertension develop more renal diseases. The subgroup analysis showed an increased incidence of renal insufficiency and renal cell carcinoma. The renin-angiotensin-aldosterone system (RAAS system) has been implicated as a possible pathomechanism. It is postulated that increased angiotensin II levels lead to a mismatch between the oxidation and reduction partners in the cell, which alters the oxidative potential of the cell and results in increased formation of radicals (ROS), most of which contain unpaired electrons in the valence shell or unstable compounds, making them particularly reactive with proteins, lipids, carbohydrates, and DNA. As a result, DNA changes occur in the form of double or single strand breaks, DNA-protein crosslinks, base modifications, and base losses, resulting in a high mutagenic potential. This approach to pathophysiology was also confirmed in the porky kidney cell model. This showed not only a change in genomic stability after exposure to elevated angiotensin II levels, but also a change in DNA depending on the duration of exposure of the cells. Next, modulation of the Nrf 2 and NF-κB transcription factors by angiotensin II and sulforaphane treatment was demonstrated. Treatment with sulforaphane showed Nrf 2 induction with increased expression of antioxidant and detoxifying enzymes. Furthermore, treatment revealed decreased NF-κB levels. When modulated by angiotensin II, cells initially showed a significantly reduced level of Nrf 2, which increased over the course of 24 hours. In addition, cells treated with angiotensin II demonstrated increased NF-κB levels. Moreover, the influence of increased glucose concentrations on progressive genomic instability, the alteration of transcription factors with increased Nrf 2 induction and with deregulation of the transcription factor NF-κB was demonstrated by treatment with sulforaphane. Because of this role in tumorigenesis, some components of the NF-κB and Nrf 2 signaling pathways, as well as Nrf 2 activators such as sulforaphane, are now important targets for the development of new drugs and therapeutic options. The importance of this is particularly evident in diabetes-induced cardiovascular complications with early drug treatment.

Molecular analysis of the cross talk between Angiotensin II (Ang II) and insulin signaling systems reveal that they are multifaceted and occur at cellular level and intracellular level. Experiments were carried out to evaluate the crosstalk between the Ang II receptors-AT1 and AT2 and the Insulin Receptor (IR) to understand the changes in the signaling pathway that could lead to the transition from hypertension to insulin resistance. Transient expression of rat AT2 in CHO cells induced co-immunoprecipitation of the AT2R with IRâ and inhibition of IRâ tyrosine phosphorylation. An AT2-peptide carrying the amino acids 226-363 (that spans 3rd intracellular loop (ICL) and C-terminal cytoplasmic domain) was sufficient for AT2- IRâ interaction in a yeast two-hybrid assay. An orthovanadate-insensitive AT2- IRâ association was also observed in human breast cancer cell line MCF-7. Interestingly, while AT2- IRâ complex formation was insensitive to pertussis toxin (PTX), AT2-mediated inhibition of IRâ phosphorylation was partially sensitive to PTX treatment in MCF-7. To address the mechanism behind the transition of an early hypertensive heart to an insulin resistant status, we investigated the changes that occur at post translational level in the IR and its downstream signaling molecules that modulate insulin signaling. Early hypertension was induced in 10-week old SD rats by 2% NaCl diet in combination with Ang II infusion. Enhanced serine phosphorylation of the IRâ suggestive of dysfunctional insulin signaling was observed in cardiac tissues as a result of the treatment. In addition, an enhanced association of both AT1R and AT2R with IRâ was observed in the heart tissue lysates from hypertensive rat heart. To evaluate the tissue effects of Ang II, we compared the transcriptome of hypertensive rat hearts to the controls. Analysis suggests that the Ang II induces multiple responses in heart tissue that result in changes to the gene expression pattern intended to promote insulin sensitivity and insulin resistance. Taken together our results suggest that exogenous Ang II and moderately high salt diet promote metabolic abnormalities in heart tissue that result in sequestration of IR and modulation of IR signaling, and significant changes in gene expression profile in the hypertensive heart.

No description available.

Hypertension and diabetes have long been closely linked. As such, the major player in the renin, angiotensin system, angiotensin II, has recently been investigated for its effects on metabolism and diabetes. Since skeletal muscle is one of the most metabolically active tissues, this study investigates the effects of angiotensin II specifically on skeletal muscle. In this study, L6 skeletal muscle cells were treated with angiotensin II for either 3 or 24 hours and a number of effects were investigated. Fatty acid oxidation and lipid synthesis was measured using [1-14C]-palmitate, glucose oxidation and glycogen synthesis were measured using 14C-glucose. In addition,mitochondrial oxidative capacity was measured using an XF 24 Flux Analyzer (Seahorse Bioscience) and reactive oxygen species measured using confocal microscopy. The clinical study involving the drug Benicar ® investigated the metabolic effects of blocking angiotensin II on skeletal muscle fatty acid oxidation, glucose oxidation, and oxidative and glycolytic enzyme activity. In L6 cells, angiotensin II significantly reduced fatty acid oxidation after 24 hours (p<0.01) and 3 hours (p<0.001) if angiotensin II was present during oxidation experiments. It also significantly reduced mitochondrial oxidative capacity (p<0.05) after 24 hours and significantly increased reactive oxygen species production (p<0.05) over 3 hours. The clinical study showed no significant effects of Benicar® on fatty acid or glucose oxidation or any enzyme activities. / Master of Science