Metabolic syndrome is a significant worldwide public health challenge and is inextricably linked to adverse renal and cardiovascular outcomes. The inhibition of the transient receptor potential cation channel subfamily C member 6 (TRPC6) has been found to ameliorate renal outcomes in the unilateral ureteral obstruction (UUO) of accelerated renal fibrosis. Therefore, the pharmacological inhibition of TPRC6 could be a promising therapeutic intervention in the progressive tubulo-interstitial fibrosis in hypertension and metabolic syndrome. In the present study, we hypothesized that the novel selective TRPC6 inhibitor SH045 (larixyl N-methylcarbamate) ameliorates UUO-accelerated renal fibrosis in a New Zealand obese (NZO) mouse model, which is a polygenic model of metabolic syndrome. The in vivo inhibition of TRPC6 by SH045 markedly decreased the mRNA expression of pro-fibrotic markers (Col1a1, Col3a1, Col4a1, Acta2, Ccn2, Fn1) and chemokines (Cxcl1, Ccl5, Ccr2) in UUO kidneys of NZO mice compared to kidneys of vehicle-treated animals. Renal expressions of intercellular adhesion molecule 1 (ICAM-1) and -smooth muscle actin (-SMA) were diminished in SH045- versus vehicle-treated UUO mice. Furthermore, renal inflammatory cell infiltration (F4/80+ and CD4+) and tubulointerstitial fibrosis (Sirius red and fibronectin staining) were ameliorated in SH045-treated NZO mice. We conclude that the pharmacological inhibition of TRPC6 might be a promising antifibrotic therapeutic method to treat progressive tubulo-interstitial fibrosis in hypertension and metabolic syndrome.

Background: A major problem in the treatment of human hypertension is the late diagnosis of hypertension and, hence, the delayed start of treatment. Very often, hypertension has existed for a long time and cardiac damage has already developed. Therefore, we tested whether late- onset antihypertensive treatment is effective in lowering blood pressure (BP) and in reducing or even preventing left ventricular hypertrophy and fibrosis. Methods: Twenty-one male 60-week-old spontaneously hypertensive rats (SHR) were included. Fourteen rats received oral treatment with captopril (CAP) either as monotherapy or combined with nifedipine (CAP + NIF) over 22 weeks. Seven untreated SHR served as controls. We examined the therapeutic effects on BP, heart weight and histological and biochemical markers of left ventricular remodeling and fibrosis. Results: At 82 weeks of age, BP was reduced in the CAP and CAP + NIF groups by 44 and 51 mmHg, respectively (p < 0.001), but not in untreated controls. Despite the late therapy start, cardiac hypertrophy and fibrosis were attenuated compared to controls. Both treatments reduced heart weight by 1.2 mg/g (25%, p = 0.001) and collagens I and III by 66% and 60%, respectively (p < 0.001), thus proving nearly equivalent cardioprotective efficacy. Conclusion: These data clearly emphasize the benefit of antihypertensive treatment in reducing BP and mitigating the development of cardiac amage even when treatment is started late in life.

In cystic fibrosis (CF) therapy, the recent approval of CF-transmembrane conductance regulator (CFTR) channel modulators is considered to be the major breakthrough. However, the current first-line approach based mainly on pulmonary function to measure effects of the novel therapy, tested by forced expiratory volumes in one second (FEV1), provides restricted sensitivity to detect early structural damages. Accordingly, there is a need for new sensitive surrogate parameters. Most interestingly, these should quantify inflammation that precedes a decline of pulmonary function. We present a novel method assessing inflammatory markers in the upper airways’ epithelial lining fluid (ELF) obtained by nasal lavage (NL). In contrast to broncho-alveolar lavage, ELF sampling by NL is an attractive method due to its limited invasiveness which allows repeated analyses, even performed in a home-based setting. In a longitudinal cohort study (ClinicalTrials.gov, Identifier: NCT02311140), we assessed changes of inflammatory mediators in 259 serially obtained nasal lavages taken up to every second day before and during therapy with ivacaftor from ten CF patients carrying a G551D mutation. Patients were trained to sample NL-fluid at home, to immediately freeze and transfer chilled secretions to centers. Neutrophil Elastase, Interleukins IL-1b, IL-6 and IL-8 in NL were quantified. During 8-12 weeks of ivacaftor-treatment, median values of IL-1b and IL-6 significantly declined 2.29-fold (2.97!1.30 pg/mL), and 1.13-fold (6.48!5.72 pg/mL), respectively. In parallel, sweat tests and pulmonary function improved considerably. This is the first study assessing changes of airway inflammation on a day-to-day basis in CF patients receiving a newly administered CFTR-modulator therapy. It proves a decline of airway inflammation during ivacaftor-therapy.

Background: Rhabdomyosarcoma (RMS) is a soft tissue malignancy of the skeletal muscle that occurs primarily in pediatric populations. The prevailing treatment for RMS is a combination of chemoradiation therapy and surgery which has contributed to its 5-year survival rate of 75%. However, the combination of RMS and chemoradiation therapy can lead to impaired muscle growth and development which results in life-long skeletal muscle atrophy and weakness for RMS survivors. Skeletal muscle is a highly plastic tissue due, in part, to dynamic interactions between muscle-resident stem and progenitor cells (i.e., satellite cells (SCs) and fibro/adipogenic progenitors (FAPs)), which are necessary for muscle maintenance, growth, and adaptation to anabolic stimuli such as resistance exercise training. There is a clear gap in research investigating whether resistance endurance training (RET) stimulates muscle growth and preserves muscle function after juvenile chemoradiation therapy. Purpose: To determine the extent to which RET ameliorates the skeletal muscle defects in a preclinical model of RMS survivorship. Hypothesis: RET will improve physical performance, muscle cross-sectional area (CSA), and stem/progenitor cell populations compared to sedentary mice following RMS and chemoradiation therapy. Methods: RMS (M3-9-M cells) was injected into a single hindlimb of juvenile (4 week) C57Bl/6 mice that underwent systemic chemotherapy followed by targeted, fractionated radiation therapy to the RMS-injected limb. Following therapy, mice underwent RET (RET; n=10) or remained sedentary (SED; n=10) for 8 weeks. Body composition and performance tests were completed pre- and post-therapy and throughout the exercise intervention. Fibre typing, cross-sectional area, myonuclear characteristics and trichrome staining were evaluated following muscle harvest and progenitor cell populations were assessed using flow cytometry. Results: RET led to increased endurance performance (p<0.0001) as well as a reduction in body fat percentage (p=0.0004). RET rescued atrophy induced by RMS+therapy as evidenced by a significant increase in gastrocnemius/soleus to body weight ratio for the RET group compared to the SED group (p=0.0303), despite the decrease in muscle weight observed in the treated limb compared to the control limb (p=0.015). A distinct increase in intramuscular fibrosis was noted in the treated limb compared to the control limb in both groups (p=0.0283). Furthermore, RET resulted in larger myofibre cross-sectional area (p<0.05) and a shift from Type IIX to IIA fibres (p<0.05). We also noted a greater Type IIA myonuclear domain in the RET group compared to the SED group (p=0.0015) and an overall decrease in myonuclear domain (the cytoplasmic volume controlled by each myonucleus) for the treated limb compared to the control limb (p<0.05). Interestingly, we noticed overall cell death and an increase in immune cells in the RMS treated limb, while exercise resulted in increased endothelial and mesenchymal stromal cells. Significance: These preclinical findings will provide the rationale for further investigation of the mechanisms responsible for the beneficial effects of RET as well as optimizing the RET protocol in this juvenile cancer survivorship model.

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