京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19609号 / 医博第4116号 / 新制||医||1015(附属図書館) / 32645 / 京都大学大学院医学研究科医学専攻 / (主査)教授 岩井 一宏, 教授 小杉 眞司, 教授 瀬原 淳子 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13126号 / 論医博第2135号 / 新制||医||1024(附属図書館) / (主査)教授 湊谷 謙司, 教授 椛島 健治, 教授 岩井 一宏 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

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Indiana University-Purdue University Indianapolis (IUPUI) / Congenital heart defects occur in approximately one percent of births every year, which makes it the most frequently occurring congenital defect in patients. The aim of this project was to use two mutant neural crest (NC) mouse models to study the mechanisms underlying congenital heart failure in utero. The first mouse model was a Pax3 systemic knockout, which was lethal by mouse gestational day 14, and had appreciably reduced numbers of migratory NC cells. The second mouse model was a Wnt1Cre-mediated NC genetic cell ablation model, which was surprisingly viable and survived to birth, despite an apparent lack of migratory NC cells. The resultant data indicated that both mouse models had similar heart structural defects including persistent truncus arteriosus, which was due to fewer or no migratory cardiac NC cells. However, in utero heart function was appreciably perturbed in Pax3 mutants when compared to that of the ablated mutant model. The loss of embryonic cardiac function in Pax3 mutants was directly attributed to a substantial decrease in the activity of the beta-adrenergic pathway. This was due to a lack of proper specification of trunk NC cells, leading to diminished levels of circulating catecholamine levels in the embryo. To definitively confirm this conclusion, poor cardiac function was successfully restored by pharmacological stimulation of the beta-adrenergic pathway via administration of isoproterenol and forskolin to pregnant dams, which led to embryonic survival of Pax3 mutants to birth. By comparison of these two mutant mouse models, perturbation in the beta-adrenergic pathway was identified as the underlying mechanism responsible for in utero heart failure and lethality in Pax3 mutant embryos. The results of this study are expected to be significant in developing future therapeutic targets for congenital heart failure in prenatal and newborn patients.

Despite advances in research and therapy, cardiovascular diseases are still the leading cause of death worldwide. A closer understanding of the endogenous protective mechanism may improve pharmacological interventions for the treatment of heart diseases. Cold acclimation or hardening has strong potential for reducing cardiovascular risk and the literature shows that it stimulates the β-adrenergic and thyroid systems in tissues. At the same time, the adrenergic system in the heart is one of the main regulators of cardiac activity. However, these signaling pathways have surprisingly not been studied at the protein level in the heart yet, and no studies can be found on the subject matter in current literature. Our results show a reduced infarct size induced by ischemic injury in cold-acclimated rats (CA) at 8 ř C for 5 weeks and then returning to normothermic conditions for 2 weeks (CAR). The aim of this dissertation is to determine, the degree of involvement of the adrenergic system in the myocardium during acclimation after 3 days, 10 days, 5 weeks of CA and subsequent CAR at the level of all three β-adrenergic receptor isoforms (β-ARs) and their signaling pathways. The results show unchanged signaling of β1-AR-Gs-adenylyl cyclase-protein kinase A in the cardioprotective regimes CA and CAR, whose...

The purpose of this study was to characterize a novel technique to study neurogenic control of cutaneous vasodilation. We monitored skin blood flow (SkBF) during in-vivo electrical stimulation (e-stim) intended to activate cutaneous nerves and used intradermal microdialysis to deliver receptor antagonists to characterize their contribution to cutaneous vasodilation. We examined the role of acetylcholine receptors (RACh), nitric oxide (NO), and vasoactive intestinal peptide receptors (RVIP) on the cutaneous vasodilation induced by e-stim in the absence of the sympathetic adrenergic nervous system. Six men and three women participated in the study. Three intradermal microdialysis probes were placed in the skin of the dorsal side of their forearm. The adrenergic nervous system was eliminated by delivery of a cocktail of phentolamine (0.01 mg/ml), propranolol (1 mM), and BIBP-3226 (10 µM). At one skin site atropine (0.1 mg/ml) was delivered to block RACh. At a second site we blocked nitric oxide synthase (NOS, 10 mM L-NAME) and RACh. Finally at the third site, we blocked RACh, NOS, and RVIP (0.47 mg/ml VIP10-28). The SkBF response to 1 minute stages of graded increases in frequency (0.2, 1, 2, 4, 8, and 32 Hz) at a current of 1.0 ± 0.1 mA was used to generate a stimulus-response curve before and after drug delivery. At skin site 1 RACh blockade decreased the area under curve (AUC) by 4% from 614 ± 279 to 591 ± 331 (p>0.05). Nitric oxide synthase and RACh blockade reduced the vasodilator response to e-stim by 23% from 1036 ± 457 to 801 ± 448 AUC (p>0.05). Combined NOS, RACh, and RVIP blockade reduced the vasodilator response by 48% from 802 ± 412 to 418 ± 268 AUC (p=0.07). RACh blockade had no effect on the vasodilator response to e-stim. However, in these preliminary studies both NOS and RVIP blockade provided some attenuation of the cutaneous vasodilator response associated with e-stim. Additional studies will focus on these two neurotransmitters as this novel method is refined. Advantages of e-stim include activating the sympathetic nervous system without activating local and humoral factors and studying neurotransmitters in an in-vivo setting during rest, thermal stress, or exercise.

Ataxia-telangiectasia mutated kinase (ATM) is a serine/threonine kinase. Mutations in the ATM gene cause a rare autosomal multisystemic disease known as Ataxia-telangiectasia (AT). Individuals with mutations in both copies of the ATM gene suffer from increased susceptibility to ionizing radiation, predisposition to cancer, insulin resistance, immune deficiency, and premature aging. Patients with one mutated allele make-up ~1.4 to 2% of the general population. These individuals are spared from most of the symptoms of the disease. However, they are predisposed to developing cancer or ischemic heart disease, and die 7-8 years earlier than the non-carriers. DNA double-strand breaks activate ATM, and active ATM is known to phosphorylate an extensive array of proteins involved in cell cycle arrest, DNA repair, and apoptosis. The importance of ATM in the regulation of DNA damage response signaling is fairly well-established. This review summarizes the role of ATM in the heart, specifically in cardiac remodeling following β-adrenergic receptor stimulation and myocardial infarction.