Heart rate changes mediate the embryotoxic effect of antiarrhythmic drugs in the chick embryo A significant increase in cardiovascular medication use during pregnancy has occurred in recent years but only limited evidence on its safety profile is available. We hypothesized that drug-induced bradycardia is the leading mechanism of developmental toxicity. We tested metoprolol, carvedilol, or ivabradine for embryotoxicity and their acute effect on chick embryonic model. We used video microscopy and ultrasound biomicroscopy. Significant dose-dependent mortality was achieved in embryos injected with carvedilol and ivabradine. In ED4 embryos, metoprolol, carvedilol and ivabradine reduced the heart rate by 33%, 27%, and 55%, respectively, compared to controls (6%). In ED8 embryos this effect was more pronounced with a heart rate reduction by 71%, 54%, 53%, respectively (controls 36%). Cardiac output decreased in all tested groups but only proved significant in the metoprolol group in ED8 embryos. The number of -adrenergic receptors showed a downward tendency during embryonic development but a negative chronotropic effect of tested drugs was increasingly pronounced with embryonic maturity. This effect was associated with reduced cardiac output in chick embryos, probably leading to premature death....

Heart rate changes mediate the embryotoxic effect of antiarrhythmic drugs in the chick embryo A significant increase in cardiovascular medication use during pregnancy has occurred in recent years but only limited evidence on its safety profile is available. We hypothesized that drug-induced bradycardia is the leading mechanism of developmental toxicity. We tested metoprolol, carvedilol, or ivabradine for embryotoxicity and their acute effect on chick embryonic model. We used video microscopy and ultrasound biomicroscopy. Significant dose-dependent mortality was achieved in embryos injected with carvedilol and ivabradine. In ED4 embryos, metoprolol, carvedilol and ivabradine reduced the heart rate by 33%, 27%, and 55%, respectively, compared to controls (6%). In ED8 embryos this effect was more pronounced with a heart rate reduction by 71%, 54%, 53%, respectively (controls 36%). Cardiac output decreased in all tested groups but only proved significant in the metoprolol group in ED8 embryos. The number of -adrenergic receptors showed a downward tendency during embryonic development but a negative chronotropic effect of tested drugs was increasingly pronounced with embryonic maturity. This effect was associated with reduced cardiac output in chick embryos, probably leading to premature death....

No / Cyclic adenosine monophosphate (cAMP)-dependent signaling modulates platelet function at sites of vascular injury. Here we show that thrombospondin-1 (TSP-1) prevents cAMP/protein kinase A (PKA) signaling through a CD36-dependent mechanism. Prostaglandin E(1) (PGE(1)) induced a robust inhibition of both platelet aggregation and platelet arrest under physiologic conditions of flow. Exogenous TSP-1 reduced significantly PGE(1)-mediated inhibition of both platelet aggregation and platelet arrest. TSP-1 prevented PGE(1)-stimulated cAMP accrual and phosphorylation of PKA substrates, through a mechanism requiring phosphodiesterase3A. TSP-1 also inhibited VASP phosphorylation stimulated by the nonhydrolyzable cAMP analog, 8-bromo-cAMP, indicating that it may regulate cAMP-mediated activation of PKA. The inhibitory effect of TSP-1 on cAMP signaling could be reproduced with a peptide possessing a CD36 binding sequence of TSP-1, while the effects of TSP-1 were prevented by a CD36 blocking antibody. TSP-1 and the CD36 binding peptide induced phosphorylation of Src kinases, p38 and JNK. Moreover, inhibition of Src kinases blocked TSP-1-mediated regulation of cAMP concentrations and the phosphorylation of VASP, indicating that TSP-1 modulated the cAMP/PKA signaling events through a tyrosine kinase-dependent pathway downstream of CD36. These data reveal a new role for TSP-1 in promoting platelet aggregation through modulation of the cAMP-PKA signaling pathway.

In this work, the influence of the second messenger cAMP on the functional plasticity of M-DC8+ dendritic cells (DC) was examined. The marker M-DC8 defines a population of native DC first described in blood. After their isolation, M-DC8+ DC acquire a mature CD83+ phenotype during a short culture ex vivo. After a challenge with LPS and IFN-g, M-DC8+ DC secrete large amounts of the proinflammatory cytokines IL-12(p70) and TNF-a surpassing by far other DC populations and monocytes. Due to their preferential induction of TH1-dominated T cell responses, M-DC8+ DC might play a role in the pathogenesis of inflammatory diseases. Different cAMP-elevating agents suppressed the proinflammatory cytokine production and enhanced the secretion of anti-inflammatory IL-10. Activity of phosphodiesterase (PDE) 4, the most important cAMP-hydrolysing enzyme in immune cells, was detected and RT-PCR revealed the expression of PDE4 subtypes 4A, 4B and 4D in M-DC8+ DC, whereas 4C was not detectable. The PDE4-specific inhibitors AWD12-281 and Roflumilast were then used to elevate cAMP concentrations. These substances have been proven to be efficient in anti-inflammatory therapies. In the presence of PDE4 inhibitors, the LPS/IFN-g-induced production of IL-12 and TNF-a was decreased by 90 % and 60 %, respectively, whereas the IL-10-release was doubled. These effects were only observed, if the PDE4 inhibitors where present from the beginning of the culture. The inhibition of the IL-12 secretion was reverted using an a-IL-10-receptor antibody. PDE4 inhibitor-treated M-DC8+ DC showed a reduced capacity to polarize TH1-cells, which was demonstrated analysing culture supernatants by ELISA and by single-cell analysis detecting intracellular IFN-g und IL-4. These results suggest that PDE4 inhibitors may not only be useful in the therapy of TH2-mediated diseases but also in TH1-dominated indications such as multiple sclerosis and Crohn´s disease. Despite the shift of the cytokine profile, the in vitro maturation of M-DC8+ DC was not affected by PDE4 inhibitors. The expression of CD83, CD80, CD86, MHC-molecules as well as CD54 and CD58, was assessed by FACS analysis. Correspondingly, in the presence of AWD12-281, M-DC8+ DC efficiently stimulated the proliferation of allogeneic CD4+CD45RA+ T-cells. In the second part of this study, the effects of an inhibition of cAMP-synthesis in M-DC8+ DC were analyzed. Two adenylyl cyclase (AC) inhibitors, 2,5-Dideoxyadenosine and SQ22536, clearly hampered the in vitro maturation of M-DC8+ DC. The expression of the DC maturation marker CD83 could be reconstituted using the stable cAMP-analogon 8-Br-cAMP. Measuring the intracellular cAMP concentration in M-DC8+ DC, initially low cAMP-levels were observed, but within 30 min the concentration raised and returned to original levels within 2 hrs. Blocking the cAMP synthesis by AC inhibitors, the LPS/IFN-g-induced production of IL-12, TNF-a and IL-10 was strongly reduced. Furthermore, it was demonstrated that M-DC8+ DC can only release IL-12 after a transient elevation of cAMP, i.e. they acquire a "license". Such a regulation of the IL-12 production has not been described before. Protein kinase A is an important effector molecule of cAMP. Inhibiting its activity resulted in a reduced expression of the DC maturation marker CD83 and a lower cytokine production underlining the importance of cAMP-signalling for the activation of M-DC8+ DC. In conclusion, this study provides evidence for a new concept of the immune-regulatory function of cAMP. Here, cAMP is essentially involved in the initial activation and maturation of DC and enables them to secrete large amounts of IL-12 and TNF-a upon stimulation with a TLR ligand. Conversely, a long-term elevation of cAMP-concentrations inhibits the proinflammatory effector functions of M-DC8+ DC and can induce anti-inflammatory responses by enhancing the secretion of IL-10. / In dieser Arbeit wurde der Einfluss des second messengers cAMP auf die funktionelle Plastizität von M-DC8+ dendritischen Zellen (DC) untersucht. Der Oberflächenmarker M-DC8 definiert eine zunächst im Blut beschriebene Population nativer DC. Nach ihrer Isolation erlangen M-DC8+ DC während einer kurzen Kultur einen maturen CD83+ Phänotyp. Nach Stimulation mit LPS und IFN-g produzieren native M-DC8+ DC deutlich höhere Mengen der proinflammatorischen Zytokine IL-12(p70) und TNF-a als andere DC-Populationen oder Monozyten. Dies resultiert in einer Programmierung TH1-dominierter T-Zellantworten. M-DC8+ DC könnten daher an der Pathogenese entzündlicher Krankheiten beteiligt sein. Unterschiedliche cAMP-erhöhende Substanzen supprimierten die proinflammatorische Zytokinproduktion und verstärkten gleichzeitig die Sekretion des anti-inflammatorischen IL-10. In M-DC8+ DC konnte die Aktivität von Phosphodiesterase (PDE) 4, dem wichtigsten cAMP-hydrolysierenden Enzym in Immunzellen, nachgewiesen werden. Durch RT-PCR wurde die Expression der PDE4-Subtypen 4A, 4B und 4D gezeigt, nicht aber 4C. Zur Erhöhung der cAMP-Konzentration wurden dann die PDE4-spezifischen Inhibitoren AWD12-281 und Roflumilast eingesetzt, deren klinische Effizienz bei anti-inflammatorischen Therapien belegt ist. Auch diese Substanzen verringerten die LPS/IFN-g-induzierte Produktion von IL-12 und TNF-a durch M-DC8+ DC um 90 % bzw. 60 %, während die IL-10-Freisetzung etwa verdoppelt wurde. Diese starken Effekte konnten nur erzielt werden, wenn die PDE4-Inhibitoren von Beginn der Kultur an eingesetzt wurden. Die Hemmung der IL-12-Sekretion wurde in Gegenwart eines a-IL-10-Rezeptor-Antikörpers aufgehoben. Unter dem Einfluss von PDE4-Inhibitoren war die TH1-Programmierung durch M-DC8+ DC deutlich reduziert, was sowohl durch die Analyse der Zellüberstände mittels ELISA als auch auf Einzelzell-Ebene durch intrazelluläre Detektion von IFN-g und IL-4 nachgewiesen wurde. Diese Ergebnisse legen nahe, dass PDE4-Inhibitoren nicht nur für TH2-vermittelte Erkrankungen sondern auch für TH1-dominierte Indikationen wie Multiple Sklerose oder Morbus Crohn von Nutzen sein könnten. Trotz der starken Modulation des Zytokinprofils blieb die in vitro-Ausreifung M-DC8+ DC unbeeinflusst von PDE4-Inhibitoren. Untersucht wurde die Expression von CD83, CD80, CD86, MHC-Molekülen, CD54 und CD58 mittels FACS-Analyse. Entsprechend induzierten M-DC8+ DC auch in Anwesenheit von AWD12-281 die Proliferation allogener CD4+CD45RA+ T-Zellen. Im zweiten Teil der Arbeit wurde untersucht, wie sich die Blockade der cAMP-Synthese auf M-DC8+ DC auswirkt. Zwei Adenylatcyclase-Inhibitoren, 2,5-Dideoxyadenosine und SQ22536, hemmten die in vitro-Maturation von M-DC8+ DC deutlich. Die CD83-Expression wurde mit 8-Br-cAMP rekonstituiert. Messungen der intrazellulären cAMP-Konzentration in unbehandelten M-DC8+ DC zeigten initial niedrige cAMP-Spiegel, die innerhalb von 30 min anstiegen und nach 2 h wieder auf das Ausgangsniveau abfielen. Die LPS/IFN-g-induzierte Produktion von IL-12, TNF-a und IL-10 wurde durch AC-Inhibitoren deutlich vermindert. M-DC8+ DC erhalten nur nach einer transienten cAMP-Erhöhung die "Lizenz" IL-12 freizusetzen. Eine derartige Regulation der IL-12-Sekretion ist bisher nicht beschrieben. Eine Hemmung des cAMP-Effektormoleküls Proteinkinase A resultierte in der reduzierten Expression des DC-Maturationsmarkers CD83 und einer verringerten Zytokinproduktion. Dies unterstreicht die Bedeutung von cAMP für die Aktivierung M-DC8+ DC. Zusammenfassend gibt diese Arbeit am Beispiel nativer humaner DC Anhalt für ein neues Konzept der immunregulatorischen Funktion von cAMP. Hierbei ist cAMP wesentlich an der Ausreifung von M-DC8+ DC beteiligt, woraufhin diese große Mengen IL-12 und TNF-a sekretieren können. Dagegen wirkt eine langfristige cAMP-Erhöhung durch die Induktion von IL-10 anti-inflammatorisch.