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.

La néphropathie aux plantes chinoises (CHN) est une maladie rénale grave qui a été décrite pour la première fois en 1993 chez des patientes ayant suivi un régime amaigrissant à base d’extraits de plantes chinoises (Aristolochia fangchi) contenant des acides aristolochiques (AA). Cette néphropathie se caractérise par une atrophie tubulaire et une fibrose interstitielle aboutissant à l’urémie terminale et se complique fréquemment de cancers des voies urinaires. Au moment d’initier ce travail, il subsistait toujours un large débat quant au rôle étiologique réel des acides aristolochiques dans la genèse de cette maladie. En effet, les gélules à visée amaigrissante contenaient d’autres substances potentiellement néphrotoxiques. Mais surtout, il n’existait aucune preuve expérimentale que les AA pouvaient induire une fibrose rénale interstitielle. Dans la première partie de ce travail, nous démontrons que l’injection par voie sous-cutanée d’AA à la dose de 10 mg/Kg/jour à des rats Wistar mâles en déplétion sodée entraîne l’apparition au 35ème jour d’une atrophie tubulaire, d’une fibrose interstitielle et d’une insuffisance rénale, reproduisant ainsi les anomalies caractéristiques de la CHN. Nous avons ensuite montré que la dexfenfluramine, substance anorexigène à action de type sérotoninergique prise concomitamment par les patientes atteintes de CHN, ne potentialise pas la toxicité rénale des AA. Enfin, la stimulation du système rénine angiotensine (SRA) par la déplétion sodée ou l’inhibition de celui-ci par un traitement pharmacologique ne modifie pas la fibrose interstitielle ni l’insuffisance rénale induite par les AA. En conclusion, nous avons réussi à développer un modèle in vivo de fibrose rénale interstitielle induite par les AA. Dès lors nous avons apporté la preuve expérimentale de l’implication des AA dans le développement de la CHN. Ce modèle a permis de démontrer que les autres éléments potentiellement néphrotoxiques contenues dans la cure d’amaigrissement (dexfenfluramine, diurétique, laxatif) n’influençaient pas l’évolution de la fibrose interstitielle, ce qui confirme que la prise isolée d’AA suffit à expliquer le développement de la CHN. Cette confirmation à d’importantes implications en santé publique dans la mesure où des plantes contenant des acides aristolochiques font toujours partie des phytothérapies traditionnelles. De plus, il est apparu que, dans ce modèle, les mécanismes de la fibrose rénale interstitielle pouvaient être largement indépendants du SRA. Enfin, de par sa durée limitée et sa grande reproductibilité, ce modèle constitue un outil expérimental d’avenir pour l’étude des mécanismes physiopathologiques de la fibrose rénale interstitielle en général.

Background: Insulin resistance may play a pathogenic role in cardiovascular disease (CVD). Resistance to insulin has been associated with obesity, hypertension, and abnormal glucose and lipid metabolism. The constellation of these features among insulin resistant subjects has been called the metabolic syndrome. Prevalence of the metabolic syndrome increases with age and is most common in the elderly. Different criteria have been proposed to define the metabolic syndrome (ATP, WHO, AACE, EGIR). Current management of metabolic syndrome focuses on the specific risk factors that the patient may have without targeting the underlying insulin resistance. Angiotensin Converting Enzyme Inhibitors (ACEI) and Angiotensin Receptor Blockers (ARB) are widely used antihypertensive medications that may improve insulin sensitivity. We hypothesize that they can be used to reduce the long term cardiovascular complications in elderly hypertensive subjects with evidence of insulin resistance. In this study, we determined the effect of ACEI/ARB on the long term development of CVD in hypertensive non-diabetic elderly patients with the metabolic syndrome, as well as in patients with insulin resistance. Methods: Our research project utilizes the Cardiovascular Health Study (CHS) dataset. This dataset is a community based observational study where elderly participants were randomly selected and followed up for 11 years and the time to any cardiovascular event was recorded. In our project, we included hypertensive, non-diabetic individuals, with evidence of metabolic syndrome or insulin resistance, but had not experienced cardiovascular events at baseline. Cox regression model was used to evaluate the effect of ACEI/ARB on the time to the first cardiovascular event compared to the other antihypertensive medications adjusting for possible confounders such as age, race, gender, smoking status, triglycerides, LDL levels, systolic blood pressure, development of diabetes, congestive heart failure (CHF) and the number of anti-hypertensives. Results: In elderly hypertensive non-diabetic subjects with the metabolic syndrome according to the ATP and the WHO criteria, the hazard ratio for CVD associated with the use of ACEI/ARB was 0.65 or 0.68 (with 95 % C.I. of [0.45, 0.98], and [0.48, 0.96]) respectively when compared to the group exposed to the other anti-hypertensives. When the metabolic syndrome was defined according to the AACE and EGIR, the use of ACE/ARB was associated with hazard ratios for CVD equal to 0.74 and 0.899, respectively (with 95 % C.I. of [0.54, 1.09] and [0.61, 1.34]) compared to the use of the other anti-hypertensives. Hypertensive non-diabetic elderly subjects who were insulin resistant as evidenced by a HOMA-IR in the upper quartile, had a hazard ratio for CVD of 0.78 (95 % C.I. [0.56, 1.09]) associated with the use of ACEI/ARB compared to the use of other anti-hypertensives. Conclusions: The effect of ACEI/ARB on the development of cardiovascular events differs according to the definition of the metabolic syndrome. Elderly hypertensive patients with the metabolic syndrome, defined by ATP and WHO, seem to have lower risk of CVD with ACEI/ARB compared to the other antihypertensive medications. However, this association is not significant in elderly hypertensive patients in the upper quartile of HOMA and in patients with the metabolic syndrome as defined by AACE and EGIR criteria.

Os receptores medeiam a maioria das respostas fisiológicas em resposta a diversidade de estímulos. A ativação da sinalização mediada pelo receptor de angiotensina II tipo 1 é o principal responsável pelos efeitos do hormônio angiotensina II (Ang II) nos tecidos alvo. No rim concentrações fisiológicas de Ang II aumentam a atividade no túbulo proximal da isoforma 3 do trocador de Na+/H+ (NHE3). Este efeito é crucial para a manutenção do volume extracelular e pressão arterial. Evidências recentes mostraram que a ativação seletiva da sinalização enviesada da beta-arrestina/ receptor AT1 induz diurese e natriurese independentemente da sinalização via proteína G. Neste estudo testamos a hipótese de que a sinalização enviesada do receptor AT1/ beta-arrestina inibe a atividade do NHE3 no túbulo proximal, bem como investigar os possíveis mecanismos moleculares que medeio este efeito. Para tal, nós determinamos os efeitos do composto TRV120023, que se liga ao receptor AT1, bloqueando o acoplamento da proteína G e estimulando a sinalização da beta-arrestina, na função do NHE3 in vivo e in vitro. A atividade do NHE3 foi medida quer em túbulo proximal nativo, por meio de microperfusão estacionária, bem como em uma linha celular de túbulo proximal de gamba (OKP), por meio de recuperação de pH intracelular dependente de Na+. Os nossos resultados mostram que o TRV120023 na concentração de 10-7 M inibe marcadamente a atividade do NHE3 em túbulo proximal quer in vivo quer in vitro, sendo que este efeito é completamente abolido nas células silenciadas para a beta-arrestina 1 e 2 através de RNA de interferência. Adicionalmente, a estimulação do NHE3 pela Ang II é completamente suprimida pelo TRV120023 quer in vivo quer in vitro. A inibição do NHE3 pelo TRV120023 foi associada com a diminuição do NHE3 expresso na superfície da membrana plasmática em células OKP e com a redistribuição entre o corpo e a base das microvilosidades em túbulo proximal de rato. A diminuição do NHE3 na superfície da membrana plasmática em células OKP estava associado com um aumento na internalização do NHE via endocitose mediada por clatrina. A inibição do NHE3 mediada pela beta-arrestina não envolve a sinalização do receptor AT2, cAMP/ PKA, Akt e ERK1/2. Estes achados indicam que a sinalização enviesada do receptor AT1/beta-arretina inibe a atividade do NHE3 em túbulo proximal, pelo menos em parte, devido a alterações na localização subcelular do NHE3 / Cell surface receptors mediate most of our physiological responses to an array of stimulus. The triggering of the angiotensin II type I (AT1) receptor signaling is the major control point in the regulation of the ultimate effects of the peptide hormone angiotensin II (Ang II) on its target tissue. In the kidney physiological concentrations of Ang II upregulate the activity of proximal tubule Na+/H+ exchanger isoform 3 (NHE3). This effect is crucial for maintenance of extracellular fluid volume homeostasis and blood pressure. Recent findings have shown that selective activation of the betaarrestin-biased AT1 receptor signalingpathway induces diuresis and natriuresis independent of G-protein mediated signaling. This study tested the hypothesis that activation of this AT1 receptor/beta-arrestin signaling inhibits NHE3 activity in proximal tubule as well as investigate the underlying molecular mechanisms mediating this effect. To this end, we determined the effects of the compound TRV120023, which binds to the AT1R, blocks G protein coupling, and stimulates beta-arrestin signaling, on NHE3 function in vivo and in vitro. NHE3 activity was measured in both native proximal tubules, by stationary microperfusion, and in opossum proximal tubule (OKP) cells, by Na+-dependent intracellular pH recovery. Our results showed that 10-7 MTRV120023 remarkably inhibited proximal tubule NHE3 activity both in vivo and in vitro, and the effect was completely abolished in OKP cells silenced for beta-arrestin 1 and 2 by small interference RNA. Additionally, stimulation of NHE3 by Ang II was completely suppressed by TRV120023 both in vivo as well as in vitro. Inhibition of NHE3 activity by TRV120023 was associated with a decrease in NHE3 surface expression in OKP cells and with a redistribution from the body to the base of the microvilli in the rat proximal tubule. The decreased surface NHE3 in OKP cells was associated with an increase in NHE3 internalization via clathrin mediated endocytic. Beta-arrestin mediated NHE3 inhibition did not involve AT2 receptor, cAMP/ PKA, Akt and ERK1/2 signaling. These findings indicate that biased signaling of the AT1 receptor/beta-arrestin pathway inhibits NHE3 activity in the proximal tubule at least in part due to changes in NHE3 subcellular localization

HINTERGRUND: Das Ziel dieser Studie bestand darin, die mögliche Rolle von zirkulierenden humanen Monozyten in der Pathologie der essentiellen Hypertonie zu untersuchen. Wir verglichen die Expressionsmuster unterschiedlicher Adhäsionsmoleküle auf isolierten Monozyten des peripheren Blutes von Normalkontrollen und Hypertonikern. Wir bestimmten die Veränderungen durch Stimulation mit Lipopolysaccharide (LPS), Angiotensin II (AT) und agonistische Angiotensin Rezeptor Typ I-Autoantikörper (AT1-AK) sowie den Einfuß des AT1-Rezeptor-Antagonist Losartan und des auch an MAC-1 bindenden Glykoprotein IIb/IIIa Rezeptor-Antikörper Abciximab. METHODIK: Blutproben von 18 Patienten mit essentieller Hypertonie und 20 gesunden Normalkontrollen wurden verglichen. Die Monozyten wurden mittels Dynabead-Negativ-Isolierung gewonnen. Die Adhäsionsmolekül-Expression wurden nach Färbung mit fluoreszenzgekoppelten Antikörpern gegen CD11a, CD11b, CD29, CD31, CD44, CD49d, CD54 und CD62L mittels FACS Messung bestimmt. ERGEBNISSE: Auf Monozyten hypertensiver Patienten ist die Expression von CD11a, CD11b und CD54 signifikant erhöht. Mit Inkubation erhöht sich die Expression von CD54 und CD44, während CD11b, CD31 und CD49d erniedrigt werden und CD11a konstant bleibt. LPS-Stimulation führt zu einer signifikanten Erhöhung der CD11b und CD54 Expression. Ausdruck der Aktivierung durch AT-Stimulation ist eine erhöhte CD11b Expression. AT1-AK erhöhen die Expression von CD11b, CD54 und CD49d signifikant. Losartan verringert nur tendenziell und teilweise die AT und AT1-AK bedingten Expressionsveränderungen. Der LPS bedingte Anstieg der CD11b Expression auf Monozyten wird durch Abciximab vermindert. SCHLUSSFOLGERUNG: Wir demonstrieren die Bedeutung voraktivierten Monozyten bei Hypertonie in der Pathogenese der Arteriosklerose. / BACKGROUND: The purpose of this study was to investigate the possible involvement of human peripheral blood monocytes in the pathology of hypertensive disease. We determined the in vitro expression patterns of adhesion molecules on isolated peripheral blood monocytes from normal controls and from hypertensive patients. We investigated and compared the ability of lipopolysaccharide (LPS), angiotensin II (Ang II) and Agonistic AT1 receptor autoantibodies (AT1-AA) to stimulate monocytes and the influence of preincubation with an Ang II type 1 receptor antagonist (losartan) or Glykoprotein IIb/IIIa rezeptor-antibody Abciximab. METHODS: Blood samples were obtained from 18 patients with essential hypertension and from 20 normotensive healthy individuals used as a control group. Peripheral blood monocytes were isolated by negative Dyna Bead Isolation. Adhesion molecules were measured using immunofluorescence of monocytes labelled with antibody against CD11a and b, CD29, CD31, CD44, CD49d, CD54 and CD62L by flow cytometry. RESULTS: The expression of CD11a, CD11b and CD54 was significantly higher in hypertensive patients versus healthy individuals directly after isolation. With incubation the expression of CD44 and CD54 was increased and the expression of CD 11b, CD31 and CD49d was decreased, whereas CD11a shows a constant expression. Monocytes showed increased expression of CD11b and CD54 after LPS stimulation. CD11b expression was significantly increased after stimulation with Ang II, after stimulation with AT1-AA Monocytes showed an increased expression of CD11b, CD54 and CD49. Losartan was partially but not significantly effective in blocking the effects of Ang II or AT1-AA stimulation. Incubation with Abciximab was reducing the LPS induced CD11b Epression. CONCLUSIONS: These data indicate that preactivated monocytes from hypertensives may be of pathogenic importance in atherosclerosis.

Os receptores medeiam a maioria das respostas fisiológicas em resposta a diversidade de estímulos. A ativação da sinalização mediada pelo receptor de angiotensina II tipo 1 é o principal responsável pelos efeitos do hormônio angiotensina II (Ang II) nos tecidos alvo. No rim concentrações fisiológicas de Ang II aumentam a atividade no túbulo proximal da isoforma 3 do trocador de Na+/H+ (NHE3). Este efeito é crucial para a manutenção do volume extracelular e pressão arterial. Evidências recentes mostraram que a ativação seletiva da sinalização enviesada da beta-arrestina/ receptor AT1 induz diurese e natriurese independentemente da sinalização via proteína G. Neste estudo testamos a hipótese de que a sinalização enviesada do receptor AT1/ beta-arrestina inibe a atividade do NHE3 no túbulo proximal, bem como investigar os possíveis mecanismos moleculares que medeio este efeito. Para tal, nós determinamos os efeitos do composto TRV120023, que se liga ao receptor AT1, bloqueando o acoplamento da proteína G e estimulando a sinalização da beta-arrestina, na função do NHE3 in vivo e in vitro. A atividade do NHE3 foi medida quer em túbulo proximal nativo, por meio de microperfusão estacionária, bem como em uma linha celular de túbulo proximal de gamba (OKP), por meio de recuperação de pH intracelular dependente de Na+. Os nossos resultados mostram que o TRV120023 na concentração de 10-7 M inibe marcadamente a atividade do NHE3 em túbulo proximal quer in vivo quer in vitro, sendo que este efeito é completamente abolido nas células silenciadas para a beta-arrestina 1 e 2 através de RNA de interferência. Adicionalmente, a estimulação do NHE3 pela Ang II é completamente suprimida pelo TRV120023 quer in vivo quer in vitro. A inibição do NHE3 pelo TRV120023 foi associada com a diminuição do NHE3 expresso na superfície da membrana plasmática em células OKP e com a redistribuição entre o corpo e a base das microvilosidades em túbulo proximal de rato. A diminuição do NHE3 na superfície da membrana plasmática em células OKP estava associado com um aumento na internalização do NHE via endocitose mediada por clatrina. A inibição do NHE3 mediada pela beta-arrestina não envolve a sinalização do receptor AT2, cAMP/ PKA, Akt e ERK1/2. Estes achados indicam que a sinalização enviesada do receptor AT1/beta-arretina inibe a atividade do NHE3 em túbulo proximal, pelo menos em parte, devido a alterações na localização subcelular do NHE3 / Cell surface receptors mediate most of our physiological responses to an array of stimulus. The triggering of the angiotensin II type I (AT1) receptor signaling is the major control point in the regulation of the ultimate effects of the peptide hormone angiotensin II (Ang II) on its target tissue. In the kidney physiological concentrations of Ang II upregulate the activity of proximal tubule Na+/H+ exchanger isoform 3 (NHE3). This effect is crucial for maintenance of extracellular fluid volume homeostasis and blood pressure. Recent findings have shown that selective activation of the betaarrestin-biased AT1 receptor signalingpathway induces diuresis and natriuresis independent of G-protein mediated signaling. This study tested the hypothesis that activation of this AT1 receptor/beta-arrestin signaling inhibits NHE3 activity in proximal tubule as well as investigate the underlying molecular mechanisms mediating this effect. To this end, we determined the effects of the compound TRV120023, which binds to the AT1R, blocks G protein coupling, and stimulates beta-arrestin signaling, on NHE3 function in vivo and in vitro. NHE3 activity was measured in both native proximal tubules, by stationary microperfusion, and in opossum proximal tubule (OKP) cells, by Na+-dependent intracellular pH recovery. Our results showed that 10-7 MTRV120023 remarkably inhibited proximal tubule NHE3 activity both in vivo and in vitro, and the effect was completely abolished in OKP cells silenced for beta-arrestin 1 and 2 by small interference RNA. Additionally, stimulation of NHE3 by Ang II was completely suppressed by TRV120023 both in vivo as well as in vitro. Inhibition of NHE3 activity by TRV120023 was associated with a decrease in NHE3 surface expression in OKP cells and with a redistribution from the body to the base of the microvilli in the rat proximal tubule. The decreased surface NHE3 in OKP cells was associated with an increase in NHE3 internalization via clathrin mediated endocytic. Beta-arrestin mediated NHE3 inhibition did not involve AT2 receptor, cAMP/ PKA, Akt and ERK1/2 signaling. These findings indicate that biased signaling of the AT1 receptor/beta-arrestin pathway inhibits NHE3 activity in the proximal tubule at least in part due to changes in NHE3 subcellular localization

No description available.

L'angiotensine-II (Ang-II), synthétisée à partir de sources extracardiaques et intracardiaques, régule l'homéostasie cardiaque en favorisant des effets mitogéniques et en promouvant la croissance cellulaire résultant d’une altération de l'expression génique. Dans cette étude, nous avons évalué la possibilité que les récepteurs de l'angiotensine-1 (AT1) ou les récepteurs de l'angiotensine-2 (AT2) situés sur l'enveloppe nucléaire régulent l’expression génique des cardiomyocytes. En analysant les noyaux cellulaires retenus des fractions de cœur de rat par immunobuvardage Western, nous avons détecté une co-purification préférentielle des protéines AT1 et AT2 avec un marqueur de la membrane nucléaire (Nup 62), par rapport aux marqueurs de la membrane plasmique (Calpactin I), de l’appareil de Golgi (GRP 78) ou du réticulum endoplasmique (GM130). La microscopie confocale a permis de démontrer la présence des AT1 et AT2 dans les membranes nucléaires. La microinjection de l’Ang-II-FITC sur des cardiomyocytes a provoqué une liaison de préférence aux sites nucléaires. Les enregistrements de transients calciques ont illustré que les AT1 nucléaires régulent le relâchement du Ca2+. L’incubation des ligands spécifiques d’AT1 et d’AT2 avec l’UTP [α32P] a résulté en une synthèse de novo d’ARN (par exemple, 16,9 ± 0,5 cpm/ng ADN contrôle vs 162,4 ± 29,7 cpm/ng ADN-Ang II, 219,4 ± 8,2 cpm/ng ADN L -162313 (AT1) et 126,5 ± 8,7 cpm/ng ADN CGP42112A (AT2), P <0,001). L’incubation des noyaux avec Ang-II augmente de façon significative l’expression de NFκB, une réponse qui est réprimée partiellement par la co-administration de valsartan ou de PD123177. Les expériences dose-réponse avec Ang-II administrée à l'ensemble des noyaux purifiés vs. aux cardiomyocytes seuls a montré une augmentation plus importante dans les niveaux d'ARNm de NFκB avec une affinité de ~ 3 fois plus grande (valeurs d’EC50 = 9 contre 28 pmol/L, respectivement), suggérant un rôle préférentiel nucléaire dans la signalisation. Par conséquent, nous avons conclu que les membranes cardiaques nucléaires possèdent des récepteurs d’Ang-II couplés à des voies de signalisation et à la transcription génique. La signalisation nucléaire pourrait jouer un rôle clé dans les changements de l'expression de gènes cardiaques, entraînant ainsi des implications mécanistiques et thérapeutiques diverses. / Angiotensin-II (Ang-II) from extracardiac sources and intracardiac synthesis regulates cardiac homeostasis, with mitogenic and growth-promoting effects largely due to altered gene-expression. In this study, the possibility that angiotensin-1 (AT1R) or angiotensin-2 (AT2R) receptors are located on the nuclear envelope and mediate effects on cardiomyocyte gene expression was assessed. Western blot tests of nucleus-enriched rat heart fractions indicated the presence of AT1R and AT2R proteins that preferentially copurified with a nuclear membrane marker (Nup 62) but not markers of plasma (Calpactin I), Golgi apparatus (GRP 78) or endoplasmic reticulum (GM130) membranes. Confocal microscopy revealed the existence of AT1R and AT2R proteins on nuclear membranes. Microinjected Ang-II preferentially bound to nuclear sites of isolated cardiomyocytes. Ca2+i-recordings on nuclear preparations demonstrated an AT1R-mediated Ca2+ release. AT1R and AT2R ligands enhanced de novo RNA synthesis in isolated cardiomyocyte nuclei incubated with [α32P]UTP (e.g. 16.9 ± 0.5 cpm/ng for DNA control vs. 162.4 ± 29.7 cpm/ng for DNA Ang-II, 219.4 ± 8.2 cpm/ng for DNA L-162313 (AT1) and 126.5 ± 8.7 cpm/ng for DNA CGP42112A (AT2), P<0.001). Ang-II application to isolated cardiomyocyte nuclei enhanced NFκB mRNA-expression, a response that was suppressed by co-administration of valsartan or PD123177. Dose-response experiments with Ang-II applied to purified nuclei vs. to whole cardiomyocytes showed a greater increase in NFκB mRNA levels at saturating concentrations with ~3 fold greater affinity (EC50 values 9 vs. 28 pmol/L, respectively), suggesting preferential nuclear signaling. These results lead us to conclude that cardiac nuclear membranes possess angiotensin receptors that couple to nuclear signaling pathways and regulate transcription. Signaling within the nuclear envelope (e.g. from intracellularly synthesized Ang-II) may play a role in Ang-II-mediated changes in cardiac gene-expression, with potentially important mechanistic and therapeutic implications.

L'angiotensine-II (Ang-II), synthétisée à partir de sources extracardiaques et intracardiaques, régule l'homéostasie cardiaque en favorisant des effets mitogéniques et en promouvant la croissance cellulaire résultant d’une altération de l'expression génique. Dans cette étude, nous avons évalué la possibilité que les récepteurs de l'angiotensine-1 (AT1) ou les récepteurs de l'angiotensine-2 (AT2) situés sur l'enveloppe nucléaire régulent l’expression génique des cardiomyocytes. En analysant les noyaux cellulaires retenus des fractions de cœur de rat par immunobuvardage Western, nous avons détecté une co-purification préférentielle des protéines AT1 et AT2 avec un marqueur de la membrane nucléaire (Nup 62), par rapport aux marqueurs de la membrane plasmique (Calpactin I), de l’appareil de Golgi (GRP 78) ou du réticulum endoplasmique (GM130). La microscopie confocale a permis de démontrer la présence des AT1 et AT2 dans les membranes nucléaires. La microinjection de l’Ang-II-FITC sur des cardiomyocytes a provoqué une liaison de préférence aux sites nucléaires. Les enregistrements de transients calciques ont illustré que les AT1 nucléaires régulent le relâchement du Ca2+. L’incubation des ligands spécifiques d’AT1 et d’AT2 avec l’UTP [α32P] a résulté en une synthèse de novo d’ARN (par exemple, 16,9 ± 0,5 cpm/ng ADN contrôle vs 162,4 ± 29,7 cpm/ng ADN-Ang II, 219,4 ± 8,2 cpm/ng ADN L -162313 (AT1) et 126,5 ± 8,7 cpm/ng ADN CGP42112A (AT2), P <0,001). L’incubation des noyaux avec Ang-II augmente de façon significative l’expression de NFκB, une réponse qui est réprimée partiellement par la co-administration de valsartan ou de PD123177. Les expériences dose-réponse avec Ang-II administrée à l'ensemble des noyaux purifiés vs. aux cardiomyocytes seuls a montré une augmentation plus importante dans les niveaux d'ARNm de NFκB avec une affinité de ~ 3 fois plus grande (valeurs d’EC50 = 9 contre 28 pmol/L, respectivement), suggérant un rôle préférentiel nucléaire dans la signalisation. Par conséquent, nous avons conclu que les membranes cardiaques nucléaires possèdent des récepteurs d’Ang-II couplés à des voies de signalisation et à la transcription génique. La signalisation nucléaire pourrait jouer un rôle clé dans les changements de l'expression de gènes cardiaques, entraînant ainsi des implications mécanistiques et thérapeutiques diverses. / Angiotensin-II (Ang-II) from extracardiac sources and intracardiac synthesis regulates cardiac homeostasis, with mitogenic and growth-promoting effects largely due to altered gene-expression. In this study, the possibility that angiotensin-1 (AT1R) or angiotensin-2 (AT2R) receptors are located on the nuclear envelope and mediate effects on cardiomyocyte gene expression was assessed. Western blot tests of nucleus-enriched rat heart fractions indicated the presence of AT1R and AT2R proteins that preferentially copurified with a nuclear membrane marker (Nup 62) but not markers of plasma (Calpactin I), Golgi apparatus (GRP 78) or endoplasmic reticulum (GM130) membranes. Confocal microscopy revealed the existence of AT1R and AT2R proteins on nuclear membranes. Microinjected Ang-II preferentially bound to nuclear sites of isolated cardiomyocytes. Ca2+i-recordings on nuclear preparations demonstrated an AT1R-mediated Ca2+ release. AT1R and AT2R ligands enhanced de novo RNA synthesis in isolated cardiomyocyte nuclei incubated with [α32P]UTP (e.g. 16.9 ± 0.5 cpm/ng for DNA control vs. 162.4 ± 29.7 cpm/ng for DNA Ang-II, 219.4 ± 8.2 cpm/ng for DNA L-162313 (AT1) and 126.5 ± 8.7 cpm/ng for DNA CGP42112A (AT2), P<0.001). Ang-II application to isolated cardiomyocyte nuclei enhanced NFκB mRNA-expression, a response that was suppressed by co-administration of valsartan or PD123177. Dose-response experiments with Ang-II applied to purified nuclei vs. to whole cardiomyocytes showed a greater increase in NFκB mRNA levels at saturating concentrations with ~3 fold greater affinity (EC50 values 9 vs. 28 pmol/L, respectively), suggesting preferential nuclear signaling. These results lead us to conclude that cardiac nuclear membranes possess angiotensin receptors that couple to nuclear signaling pathways and regulate transcription. Signaling within the nuclear envelope (e.g. from intracellularly synthesized Ang-II) may play a role in Ang-II-mediated changes in cardiac gene-expression, with potentially important mechanistic and therapeutic implications.

En France, le syndrome coronaire aigu (SCA) représente environ 100 000 hospitalisations par an. Il est recommandé, en prévention secondaire du SCA, un traitement combinant quatre classes médicamenteuses : bêtabloquants, antiagrégants plaquettaires, statines, et inhibiteurs de l’enzyme de conversion ou antagonistes des récepteurs à l’angiotensine II(combinaison BASI). L’objectif de ce travail était l’étude, en situation réelle de soin et en population générale, de l’utilisation et de l’effectivité de la combinaison thérapeutique recommandée en prévention secondaire du SCA. Nous avons d’abord exploré le potentiel représenté par les bases de données médicoadministratives françaises pour cette évaluation. Nous avons ensuite étudié l’utilisation de la combinaison BASI : 42 % des patients étaient traités par la combinaison BASI en post-SCA et 57 % d’entre eux étaient encore traités à deux ans ; la persistance au traitement était plus faible chez les patients âgés, chez ceux ayant d’autres co-morbidités et chez ceux ayant eu un SCA de nature autre qu’un infarctus du myocarde.Nous avons enfin étudié l’effectivité de la combinaison BASI : la combinaison BASI était la combinaison thérapeutique la plus effective à long terme après un SCA chez les patients avec antécédent d’insuffisance cardiaque ; chez les patients sans antécédent de ce type la combinaison sans bêtabloquants n’était pas associée à une augmentation du risque.Ces résultats permettent de reconsidérer l’intérêt à long terme de l’ensemble de la combinaison BASI en post-SCA chez tous les patients et mettent en avant la nécessité de renforcer les stratégies d’éducation thérapeutique. / Acute coronary syndrome (ACS) causes approximately 100,000 hospitalisations per year in France. In secondary prevention of ACS, guidelines advocate pharmacological treatment combining four drug classes: beta-blockers, antiplatelet agents, statins and angiotensin converting enzyme inhibitors or angiotensin receptor blockers (recommended combination).The aim of this work was to study, in real life and among the general population, the use and the effectiveness of the recommended combination for secondary prevention of ACS.Firstly, we explored the potential represented by the French claims databases in this context. Secondly, we studied the use of the recommended combination: 42% of patients were treated with the recommended combination in post-ACS and 57% of them were still treated two years after; persistence to combination was lower in older patients, in those with other comorbidities and those who had an ACS different of myocardial infarction. Thirdly, we studied the effectiveness of the recommended combination: the recommended combination was the most effective combination therapy at long-term in post-ACS patients with history of heart failure; in patients without such history the combination without betablockers was not associated with an increased risk. These results could help reconsidering the long-term interest of the full recommended combination in all ACS patients and highlight the need to strengthen patient education strategies.